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Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18813.67},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":22757.98},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8145.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":17445.03},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25888.15},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":32257.66},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8461.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8105.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16134.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8382.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17555.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8453.69,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy With Mcc","code_information":[{"code":"739","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":31538.7,"maximum":134433.82,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":121915.52},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32000.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":78406.0},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":94843.88},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31692.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":72702.18},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":107888.86},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":134433.82},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32923.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31538.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":62778.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32615.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":68308.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32892.55,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inflammation Of The Male Reproductive System Without Mcc","code_information":[{"code":"728","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7688.39,"maximum":30437.85,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27603.51},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7800.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17752.3},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":21474.09},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7725.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":16460.87},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24427.67},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":30437.85},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8025.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7688.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15304.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7950.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16651.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8018.43,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":51845.59,"10th_percentile":51845.59,"90th_percentile":51845.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Penis Procedures With Cc/Mcc","code_information":[{"code":"709","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":20733.08,"maximum":87317.45,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":79186.56},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21036.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":50926.26},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":61602.99},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20834.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":47221.51},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":70075.96},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":87317.45},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21643.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20733.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":41269.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21441.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":44904.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21623.09,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Renal Failure Without Cc/Mcc","code_information":[{"code":"684","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5873.55,"maximum":22524.46,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20427.01},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5959.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13136.97},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":15891.14},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5902.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":12181.29},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18076.83},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":22524.46},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6131.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5873.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11691.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6074.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":12721.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6125.68,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Transurethral Procedures Without Cc/Mcc","code_information":[{"code":"670","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9117.72,"maximum":36670.25,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33255.56},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9251.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21387.23},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":25871.09},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9162.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":19831.37},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29429.43},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":36670.25},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9518.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9117.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18149.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9429.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":19747.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9509.12,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Minor Bladder Procedures With Mcc","code_information":[{"code":"662","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":27052.78,"maximum":114873.6,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":104176.72},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27448.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":66997.87},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":81044.03},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27184.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":62123.96},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":92190.95},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":114873.6},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28240.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27052.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":53849.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27976.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":58592.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28214.07,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Bladder Procedures With Cc","code_information":[{"code":"654","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":24796.48,"maximum":105035.33,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":95254.58},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25159.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":61259.88},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":74103.07},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24917.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":56803.4},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":84295.32},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":105035.33},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25885.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24796.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":49358.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25643.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":53705.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25860.92,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inborn And Other Disorders Of Metabolism","code_information":[{"code":"642","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12945.34,"maximum":53360.04,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48391.22},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13134.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31121.24},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":37645.83},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13008.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":28857.25},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42823.7},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":53360.04},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13513.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12945.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25768.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13387.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":28037.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13501.04,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"O.R. Procedures For Obesity With Cc","code_information":[{"code":"620","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14478.79,"maximum":60046.46,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":54455.01},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14690.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35020.97},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":42363.14},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14549.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":32473.29},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":48189.83},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":60046.46},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15114.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14478.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28820.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14973.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":31358.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15100.32,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Minor Skin Disorders With Mcc","code_information":[{"code":"606","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13729.27,"maximum":56778.29,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51491.17},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13930.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33114.87},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":40057.43},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13796.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":30705.85},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45566.99},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":56778.29},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14332.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13729.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27328.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14198.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29735.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14318.62,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignant Breast Disorders With Cc","code_information":[{"code":"598","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10442.93,"maximum":42448.64,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38495.88},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10595.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24757.37},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":29947.77},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10493.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":22956.34},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34066.84},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":42448.64},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10901.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10442.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20787.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10799.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":22617.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10891.21,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Breast Biopsy, Local Excision And Other Breast Procedures With Cc/Mcc","code_information":[{"code":"584","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19129.07,"maximum":80323.35,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":72843.74},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19409.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46847.08},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":56668.61},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19222.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":43439.08},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":64462.9},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":80323.35},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19968.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19129.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":38077.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19782.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":41430.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19950.22,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc","code_information":[{"code":"576","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":42883.86,"maximum":183902.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":166778.03},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43511.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":107257.86},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":129744.57},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43093.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":99455.15},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":147589.84},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":183902.83},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44766.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42883.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":85361.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44348.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":92880.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44724.73,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Musculoskeletal System And Connective Tissue Diagnoses With Cc","code_information":[{"code":"565","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9092.76,"maximum":36561.44,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33156.88},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9225.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21323.77},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":25794.32},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9137.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":19772.52},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29342.11},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":36561.44},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9491.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9092.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18099.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9403.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":19693.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9483.09,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Tendonitis, Myositis And Bursitis With Mcc","code_information":[{"code":"557","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13502.96,"maximum":55791.46,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50596.23},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13700.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32539.32},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":39361.22},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13568.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":30172.17},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":44775.02},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":55791.46},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14095.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13502.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26878.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13964.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29245.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14082.6,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":10709.69,"10th_percentile":10709.69,"90th_percentile":10709.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Septic Arthritis With Cc","code_information":[{"code":"549","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11096.07,"maximum":45296.56,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41078.6},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11258.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26418.36},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":31957.0},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11150.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":24496.5},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36352.41},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":45296.56},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11583.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11096.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22087.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11474.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":24032.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11572.38,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Osteomyelitis Without Cc/Mcc","code_information":[{"code":"541","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7483.59,"maximum":29544.82,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26793.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7593.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17231.46},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":20844.05},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7520.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":15977.92},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23710.98},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":29544.82},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7812.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7483.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14896.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7739.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16208.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7804.83,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Fractures Of Femur With Mcc","code_information":[{"code":"533","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14198.26,"maximum":58823.24,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53345.7},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14406.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34307.55},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":41500.15},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14267.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":31811.77},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":47208.15},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":58823.24},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14821.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14198.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28262.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14683.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":30751.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14807.75,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Musculoskeletal System And Connective Tissue O.R. Procedures With Mcc","code_information":[{"code":"515","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":28131.87,"maximum":119578.86,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":108443.83},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28543.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":69742.12},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":84363.62},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28269.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":64668.57},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":95967.12},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":119578.86},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29366.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28131.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":55997.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29092.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":60929.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29339.49,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Thumb Or Joint Procedures","code_information":[{"code":"506","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12318.01,"maximum":50624.68,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45910.58},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12498.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29525.89},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":35716.02},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12378.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":27377.97},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40628.46},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":50624.68},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12858.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12318.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24519.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12738.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":26679.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12846.78,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc/Mcc","code_information":[{"code":"498","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":26668.12,"maximum":113196.37,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":102655.67},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27058.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":66019.65},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":79860.73},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26798.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":61216.91},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":90844.9},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":113196.37},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27838.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26668.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":53083.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27578.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":57759.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27812.9,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Knee Procedures Without Principal Diagnosis Of Infection With Cc/Mcc","code_information":[{"code":"488","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15929.64,"maximum":66372.67,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":60192.13},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16162.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":38710.61},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":46826.32},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16007.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":35894.52},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":53266.89},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":66372.67},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16628.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15929.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31708.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16473.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":34501.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16613.45,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Biopsies Of Musculoskeletal System And Connective Tissue Without Cc/Mcc","code_information":[{"code":"479","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16704.11,"maximum":69749.65,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":63254.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16948.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40680.17},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":49208.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16785.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":37720.8},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":55977.06},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":69749.65},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17437.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16704.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":33250.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17274.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":36178.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17421.16,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cervical Spinal Fusion With Mcc","code_information":[{"code":"471","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":42259.97,"maximum":181182.48,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":164311.0},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42878.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":105671.27},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":127825.35},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42466.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":97983.98},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":145406.64},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":181182.48},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44115.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42259.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":84120.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43702.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":91528.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44074.06,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Multiple Level Spinal Fusion Except Cervical Without Mcc","code_information":[{"code":"448","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":37200.95,"maximum":159123.3,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":144305.94},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37745.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":92805.67},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":112262.46},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37382.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":86054.31},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":127703.21},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":159123.3},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38834.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37200.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":74049.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38471.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":80571.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38797.87,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Disorders Of Pancreas Except Malignancy Without Cc/Mcc","code_information":[{"code":"440","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6055.12,"maximum":23316.17,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21145.0},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6143.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13598.72},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":16449.7},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6084.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":12609.45},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18712.22},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":23316.17},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6320.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6055.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12052.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6261.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":13114.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6315.04,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":22759.58,"10th_percentile":22759.58,"90th_percentile":22759.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14020.01,"10th_percentile":14020.01,"90th_percentile":14020.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cirrhosis And Alcoholic Hepatitis With Mcc","code_information":[{"code":"432","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17644.66,"maximum":73850.8,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":66973.91},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17902.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":43072.09},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":52102.19},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17730.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":39938.71},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":59268.41},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":73850.8},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18419.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17644.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":35122.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18247.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":38215.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18402.09,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1570.27,"10th_percentile":1570.27,"90th_percentile":1570.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":5464.09,"10th_percentile":5464.09,"90th_percentile":5464.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Hepatobiliary Or Pancreas O.R. Procedures With Mcc","code_information":[{"code":"423","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":36445.41,"maximum":155828.87,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":141318.28},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36978.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":90884.25},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":109938.22},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36623.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":84272.68},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":125059.29},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":155828.87},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38045.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36445.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":72545.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37689.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":78935.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38009.9,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cholecystectomy Except By Laparoscope Without C.D.E. With Cc","code_information":[{"code":"415","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18492.28,"maximum":77546.72,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":70325.67},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18762.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45227.66},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":54709.68},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18582.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":41937.48},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":62234.54},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":77546.72},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19304.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18492.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":36809.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19123.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":40051.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19286.1,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pancreas, Liver And Shunt Procedures Without Cc/Mcc","code_information":[{"code":"407","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19808.02,"maximum":83283.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":75528.55},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20097.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":48573.73},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":58757.25},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19904.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":45040.12},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":66838.81},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":83283.83},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20677.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19808.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":39428.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20484.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":42901.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20658.32,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Wound Debridements For Injuries Without Cc/Mcc","code_information":[{"code":"903","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10772.51,"maximum":43885.73,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39799.15},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10930.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25595.53},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":30961.65},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10825.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":23733.52},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35220.16},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":43885.73},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11245.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10772.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21443.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11140.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":23331.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11234.94,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Behavioral And Developmental Disorders","code_information":[{"code":"886","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18566.29,"maximum":77869.41,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":70618.31},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18837.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45415.87},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":54937.34},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18656.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":42111.99},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":62493.51},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":77869.41},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19381.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18566.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":36956.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19200.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":40211.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19363.28,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc","code_information":[{"code":"872","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9513.57,"maximum":38396.26,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34820.85},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9652.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22393.9},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":27088.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9559.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":20764.8},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30814.63},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":38396.26},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9931.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9513.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18937.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9838.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":20605.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9921.96,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"1 through 10","median_amount":14541.09,"10th_percentile":14541.09,"90th_percentile":19898.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8655.4,"10th_percentile":7720.28,"90th_percentile":8677.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":19193.51,"10th_percentile":19193.51,"90th_percentile":19193.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10266.7,"10th_percentile":10266.7,"90th_percentile":10266.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21876.26,"10th_percentile":21273.82,"90th_percentile":21876.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":5804.12,"10th_percentile":5804.12,"90th_percentile":5804.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":17226.17,"10th_percentile":17226.17,"90th_percentile":17226.17},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":8285.3,"10th_percentile":8285.3,"90th_percentile":8285.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8332.39,"10th_percentile":8332.39,"90th_percentile":8332.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Acute Leukemia With Cc","code_information":[{"code":"835","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18656.64,"maximum":78263.39,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":70975.6},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18929.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45645.65},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":55215.3},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18747.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":42325.05},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":62809.7},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":78263.39},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19475.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18656.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37136.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19293.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":40407.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19457.51,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Antepartum Diagnoses With O.R. Procedures Without Cc/Mcc","code_information":[{"code":"819","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8107.46,"maximum":32265.17,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29260.68},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8226.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18818.05},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":22763.27},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8147.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":17449.09},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25894.17},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":32265.17},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8463.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8107.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16138.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8384.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17559.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8455.49,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Red Blood Cell Disorders With Mcc","code_information":[{"code":"811","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12792.16,"maximum":52692.14,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47785.52},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12979.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30731.7},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":37174.63},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12854.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":28496.06},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42287.69},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":52692.14},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13353.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12792.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25463.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13228.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":27705.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13341.29,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":5559.74,"10th_percentile":5559.74,"90th_percentile":5559.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":51337.03,"10th_percentile":51337.03,"90th_percentile":51337.03},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other O.R. Procedures Of The Blood And Blood Forming Organs With Cc","code_information":[{"code":"803","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16704.11,"maximum":69749.65,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":63254.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16948.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40680.17},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":49208.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16785.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":37720.8},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":55977.06},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":69749.65},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17437.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16704.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":33250.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17274.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":36178.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17421.16,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5095.99,"10th_percentile":5095.99,"90th_percentile":5095.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"13","median_amount":652.91,"10th_percentile":652.91,"90th_percentile":652.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":623.23,"10th_percentile":623.23,"90th_percentile":623.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cesarean Section Without Sterilization With Cc","code_information":[{"code":"787","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10318.15,"maximum":41904.57,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38002.47},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10469.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24440.05},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":29563.93},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10368.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":22662.11},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33630.2},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":41904.57},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10771.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10318.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20538.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10670.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":22347.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10761.08,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"1 through 10","median_amount":15869.73,"10th_percentile":15869.73,"90th_percentile":15869.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":25460.0,"10th_percentile":25460.0,"90th_percentile":25460.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":4185.78,"10th_percentile":4185.78,"90th_percentile":4185.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":3399.15,"10th_percentile":3399.15,"90th_percentile":3399.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Postpartum And Post Abortion Diagnoses With O.R. Procedures","code_information":[{"code":"769","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15248.97,"maximum":63404.68,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57500.51},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15472.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36979.58},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":44732.39},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15323.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":34289.42},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":50884.95},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":63404.68},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15918.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15248.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30353.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15769.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":33027.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15903.56,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignancy, Female Reproductive System With Cc","code_information":[{"code":"755","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10068.61,"maximum":40816.43,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37015.66},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10215.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23805.42},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":28796.24},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10117.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":22073.64},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32756.92},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":40816.43},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10510.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10068.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20041.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10412.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":21807.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10500.82,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"D&C, Conization, Laparoscopy And Tubal Interruption With Cc/Mcc","code_information":[{"code":"744","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18340.83,"maximum":76886.33,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":69726.77},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18609.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":44842.5},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":54243.78},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18430.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":41580.34},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":61704.55},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":76886.33},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19146.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18340.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":36508.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18967.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":39723.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19128.14,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc","code_information":[{"code":"736","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":31467.27,"maximum":134122.39,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":121633.09},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31927.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":78224.36},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":94624.16},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31620.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":72533.75},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":107638.92},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":134122.39},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32848.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31467.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":62636.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32541.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":68153.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32818.06,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Benign Prostatic Hypertrophy With Mcc","code_information":[{"code":"725","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10777.67,"maximum":43908.24,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39819.57},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10935.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25608.66},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":30977.53},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10830.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":23745.7},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35238.23},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":43908.24},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11250.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10777.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21453.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11145.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":23342.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11240.32,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Transurethral Prostatectomy Without Cc/Mcc","code_information":[{"code":"714","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9807.01,"maximum":39675.76,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35981.21},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9950.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23140.14},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":27991.49},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9854.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":21456.76},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31841.49},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":39675.76},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10237.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9807.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19521.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10141.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":21240.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10227.99,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":23140.14,"10th_percentile":23140.14,"90th_percentile":23140.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Kidney And Urinary Tract Diagnoses Without Cc/Mcc","code_information":[{"code":"700","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6644.57,"maximum":25886.43,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23475.92},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6741.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15097.77},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":18263.03},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6676.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":13999.45},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20774.96},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":25886.43},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6936.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6644.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13226.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6871.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14391.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6929.8,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Urinary Tract Infections Without Mcc","code_information":[{"code":"690","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7673.76,"maximum":30374.06,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27545.67},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7786.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17715.1},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":21429.08},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7711.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":16426.37},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24376.47},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":30374.06},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8010.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7673.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15274.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7935.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16620.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8003.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":17209.82,"10th_percentile":17209.82,"90th_percentile":17209.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2068.37,"10th_percentile":2068.37,"90th_percentile":2068.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16121.97,"10th_percentile":16121.97,"90th_percentile":16121.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":7061.31,"10th_percentile":7061.31,"90th_percentile":7061.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Kidney And Urinary Tract Procedures Without Cc/Mcc","code_information":[{"code":"675","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14832.47,"maximum":61588.61,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55853.56},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15049.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35920.4},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":43451.14},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14904.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":33307.29},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":49427.48},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":61588.61},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15483.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14832.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29524.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15338.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":32124.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15469.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Prostatectomy Without Cc/Mcc","code_information":[{"code":"667","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10226.94,"maximum":41506.84,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37641.77},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10376.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24208.08},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":29283.33},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10276.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":22447.01},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33311.0},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":41506.84},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10675.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10226.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20357.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10576.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":22150.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10665.95,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Ureter Procedures For Non-Neoplasm With Mcc","code_information":[{"code":"659","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":22572.89,"maximum":95339.65,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":86461.75},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22903.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":55605.06},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":67262.7},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22683.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":51559.94},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":76514.12},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":95339.65},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23563.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22572.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":44932.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23343.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":48889.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23541.87,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20453.18,"10th_percentile":20453.18,"90th_percentile":20453.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney Transplant With Hemodialysis Without Mcc","code_information":[{"code":"651","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":32597.14,"maximum":139049.03,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":126100.96},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33074.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":81097.73},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":98099.94},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32756.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":75198.09},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":111592.76},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":139049.03},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34028.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32597.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":64885.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33710.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":70600.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33996.43,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Diabetes Without Cc/Mcc","code_information":[{"code":"639","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6053.39,"maximum":23308.67,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21138.19},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6141.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13594.34},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":16444.41},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6082.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":12605.39},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18706.2},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":23308.67},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6319.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6053.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12049.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6260.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":13110.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6313.25,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Thyroid, Parathyroid And Thyroglossal Procedures With Mcc","code_information":[{"code":"625","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":26696.52,"maximum":113320.19,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":102767.96},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27087.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":66091.87},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":79948.09},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26826.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":61283.87},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":90944.27},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":113320.19},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27868.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26696.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":53140.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27608.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":57820.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27842.52,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With Cc","code_information":[{"code":"617","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16802.21,"maximum":70177.4,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":63642.57},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17048.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40929.65},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":49510.58},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16884.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":37952.13},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":56320.34},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":70177.4},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17539.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16802.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":33445.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17375.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":36391.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17523.48,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":9601.19,"10th_percentile":9601.19,"90th_percentile":9601.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cellulitis Without Mcc","code_information":[{"code":"603","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8202.12,"maximum":32677.91,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29634.99},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8322.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19058.78},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":23054.46},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8242.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":17672.3},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26225.41},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":32677.91},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8562.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8202.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16326.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8482.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17764.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8554.21,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7127.42,"10th_percentile":7127.42,"90th_percentile":7127.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":25300.53,"10th_percentile":25300.53,"90th_percentile":25300.53},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":5900.52,"10th_percentile":5900.52,"90th_percentile":5900.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Skin Disorders With Mcc","code_information":[{"code":"595","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18956.96,"maximum":79572.91,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":72163.18},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19234.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46409.4},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":56139.17},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19049.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":43033.24},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":63860.64},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":79572.91},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19789.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18956.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37734.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19604.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":41058.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19770.73,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Skin, Subcutaneous Tissue And Breast Procedures Without Cc/Mcc","code_information":[{"code":"581","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13126.05,"maximum":54148.0,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49105.81},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13318.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31580.8},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":38201.74},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13190.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":29283.39},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":43456.07},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":54148.0},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13702.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13126.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26127.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13574.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":28429.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13689.51,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Graft For Skin Ulcer Or Cellulitis With Mcc","code_information":[{"code":"573","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":57084.24,"maximum":245821.63,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":222931.04},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57919.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":143370.84},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":173428.66},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57362.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":132941.01},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":197282.31},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":245821.63},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":59590.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57084.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":113628.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":59033.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":123636.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":59534.68,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh With Mcc","code_information":[{"code":"562","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12968.57,"maximum":53461.35,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48483.09},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13158.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31180.32},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":37717.31},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13031.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":28912.04},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42905.0},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":53461.35},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13537.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12968.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25814.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13411.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":28088.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13525.27,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":286.0,"10th_percentile":286.0,"90th_percentile":286.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Bone Diseases And Arthropathies Without Mcc","code_information":[{"code":"554","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7851.03,"maximum":31147.01,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28246.64},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7965.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18165.91},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":21974.41},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7889.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":16844.39},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24996.8},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":31147.01},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8195.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7851.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15627.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8119.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17004.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8188.05,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Connective Tissue Disorders With Cc","code_information":[{"code":"546","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10633.1,"maximum":43277.87,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39247.9},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10788.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25241.01},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":30532.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10684.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":23404.79},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34732.33},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":43277.87},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11099.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10633.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21165.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10996.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":23029.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11089.55,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Sprains, Strains, And Dislocations Of Hip, Pelvis And Thigh Without Cc/Mcc","code_information":[{"code":"538","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6906.17,"maximum":27027.1,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24510.37},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7007.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15763.05},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":19067.78},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6939.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":14616.33},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21690.39},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":27027.1},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7209.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6906.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13746.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7141.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14957.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7202.63,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Back And Neck Procedures Except Spinal Fusion Without Cc/Mcc","code_information":[{"code":"520","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13563.19,"maximum":56054.12,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50834.43},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13761.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32692.51},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":39546.52},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13629.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":30314.22},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":44985.81},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":56054.12},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14158.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13563.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26998.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14026.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29375.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14145.41,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures Without Cc/Mcc","code_information":[{"code":"512","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14952.95,"maximum":62113.92,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56329.95},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15171.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36226.77},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":43821.75},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15025.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":33591.38},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":49849.06},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":62113.92},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15609.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14952.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29764.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15463.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":32385.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15594.83,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Psychoses","code_information":[{"code":"885","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12727.62,"maximum":52410.73,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47530.31},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12913.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30567.57},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":36976.09},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12789.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":28343.87},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42061.84},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":52410.73},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13286.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12727.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25334.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13162.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":27566.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13273.98,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc","code_information":[{"code":"871","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17423.5,"maximum":72886.49,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":66099.39},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17678.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42509.67},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":51421.86},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17508.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":39417.21},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":58494.5},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":72886.49},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18188.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17423.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34682.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18018.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":37736.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18171.44,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15798.06,"10th_percentile":6995.6,"90th_percentile":15832.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":39417.21,"10th_percentile":39417.21,"90th_percentile":58494.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15764.13,"10th_percentile":14955.91,"90th_percentile":17050.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"1 through 10","median_amount":20990.52,"10th_percentile":20990.52,"90th_percentile":20990.52},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":10787.9,"10th_percentile":10787.9,"90th_percentile":10787.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":39309.34,"10th_percentile":39309.34,"90th_percentile":54790.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":6070.86,"10th_percentile":6070.86,"90th_percentile":6070.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":15984.64,"10th_percentile":15984.64,"90th_percentile":26573.09},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"17","median_amount":14283.96,"10th_percentile":11758.28,"90th_percentile":15949.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Leukemia With Mcc","code_information":[{"code":"834","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":47949.77,"maximum":205992.03,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":186810.32},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48651.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":120140.97},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":145328.63},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48183.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":111401.05},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":165317.36},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":205992.03},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50054.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47949.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":95445.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49587.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":103852.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50008.1,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":45524.63,"10th_percentile":45524.63,"90th_percentile":45524.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Antepartum Diagnoses With O.R. Procedures With Cc","code_information":[{"code":"818","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10683.02,"maximum":43495.5,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39445.26},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10839.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25367.93},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":30686.34},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10735.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":23522.49},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34906.99},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":43495.5},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11152.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10683.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21264.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11047.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":23137.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11141.61,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Coagulation Disorders ","code_information":[{"code":"810","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9714.07,"maximum":39270.53,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35613.7},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9856.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22903.79},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":27705.6},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9761.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":21237.61},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31516.27},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":39270.53},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10140.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9714.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19336.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10045.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":21039.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10131.06,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other O.R. Procedures Of The Blood And Blood Forming Organs With Mcc","code_information":[{"code":"802","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":34991.98,"maximum":149491.4,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":135570.95},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35504.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":87188.04},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":105467.1},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35162.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":80845.36},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":119973.2},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":149491.4},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36528.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34991.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":69652.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36186.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":75787.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36494.08,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Neonate With Other Significant Problems","code_information":[{"code":"794","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13408.3,"maximum":55378.72,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50221.93},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13604.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32298.6},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":39070.02},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13473.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":29948.96},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":44443.78},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":55378.72},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13996.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13408.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26689.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13866.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29040.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13983.88,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":623.23,"10th_percentile":623.23,"90th_percentile":623.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"1 through 10","median_amount":2470.74,"10th_percentile":2470.74,"90th_percentile":2470.74},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"13","median_amount":970.95,"10th_percentile":652.91,"90th_percentile":970.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":926.81,"10th_percentile":926.81,"90th_percentile":3021.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cesarean Section Without Sterilization With Mcc","code_information":[{"code":"786","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14902.17,"maximum":61892.54,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56129.19},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15120.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36097.66},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":43665.56},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14974.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":33471.65},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":49671.39},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":61892.54},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15556.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14902.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29663.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15411.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":32275.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15541.87,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":41328.77,"10th_percentile":41328.77,"90th_percentile":41328.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":4343.74,"10th_percentile":4343.74,"90th_percentile":4343.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Vaginal Delivery With O.R. Procedures Except Sterilization And/Or D&C","code_information":[{"code":"768","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9929.2,"maximum":40208.58,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36464.4},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10074.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23450.89},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":28367.4},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9977.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":21744.91},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32269.09},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":40208.58},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10365.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9929.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19764.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10268.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":21505.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10355.42,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":2814.68,"10th_percentile":2814.68,"90th_percentile":2814.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignancy, Female Reproductive System With Mcc","code_information":[{"code":"754","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16556.1,"maximum":69104.27,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62669.37},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16798.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40303.76},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":48753.48},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16636.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":37371.78},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":55459.11},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":69104.27},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17282.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16556.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32955.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17121.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":35858.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17266.8,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Uterine And Adnexa Procedures For Non-Malignancy Without Cc/Mcc","code_information":[{"code":"743","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11384.35,"maximum":46553.55,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42218.54},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11550.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27151.48},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":32843.81},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11439.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":25176.28},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":37361.2},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":46553.55},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11884.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11384.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22660.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11773.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":24656.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11873.04,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":24905.18,"10th_percentile":24905.18,"90th_percentile":24905.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy Without Cc/Mcc","code_information":[{"code":"735","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12286.17,"maximum":50485.85,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45784.67},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12465.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29444.92},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":35618.08},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12346.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":27302.89},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40517.04},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":50485.85},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12825.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12286.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24456.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12705.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":26610.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12813.58,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignancy, Male Reproductive System Without Cc/Mcc","code_information":[{"code":"724","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6350.27,"maximum":24603.18,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22312.16},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6443.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14349.34},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":17357.69},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6381.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":13305.46},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19745.09},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":24603.18},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6629.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6350.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12640.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6567.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":13753.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6622.87,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Transurethral Prostatectomy With Cc/Mcc","code_information":[{"code":"713","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13644.94,"maximum":56410.57,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51157.7},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13844.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32900.41},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":39798.0},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13711.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":30506.99},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45271.88},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":56410.57},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14243.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13644.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27160.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14110.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29552.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14230.68,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Kidney And Urinary Tract Diagnoses With Cc","code_information":[{"code":"699","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9442.14,"maximum":38084.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34538.42},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9580.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22212.26},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":26869.08},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9488.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":20596.38},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30564.7},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":38084.83},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9856.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9442.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18794.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9764.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":20450.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9847.46,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21484.87,"10th_percentile":21484.87,"90th_percentile":21484.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":4650.18,"10th_percentile":4650.18,"90th_percentile":4650.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":7007.5,"10th_percentile":7007.5,"90th_percentile":7007.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Urinary Tract Infections With Mcc","code_information":[{"code":"689","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10692.48,"maximum":43536.78,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39482.69},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10848.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25392.01},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":30715.46},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10744.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":23544.81},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34940.11},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":43536.78},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11161.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10692.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21283.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11057.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":23158.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11151.48,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9725.96,"10th_percentile":9725.96,"90th_percentile":9725.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10257.13,"10th_percentile":10257.13,"90th_percentile":10257.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":8147.43,"10th_percentile":8147.43,"90th_percentile":8147.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Kidney And Urinary Tract Procedures With Cc","code_information":[{"code":"674","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":20832.05,"maximum":87748.95,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":79577.88},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21136.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":51177.92},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":61907.42},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20933.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":47454.87},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":70422.26},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":87748.95},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21746.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20832.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":41466.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21543.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":45119.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21726.3,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Prostatectomy With Cc","code_information":[{"code":"666","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15760.97,"maximum":65637.23,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59525.18},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15991.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":38281.68},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":46307.47},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15837.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":35496.8},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":52676.67},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":65637.23},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16452.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15760.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31372.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16299.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":34135.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16437.54,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Ureter Procedures For Neoplasm Without Cc/Mcc","code_information":[{"code":"658","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14061.44,"maximum":58226.64,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52804.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14267.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33959.59},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":41079.25},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14130.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":31489.13},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46729.35},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":58226.64},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14678.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14061.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27989.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14541.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":30455.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14665.06,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney Transplant With Hemodialysis With Mcc","code_information":[{"code":"650","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":41164.52,"maximum":176405.93,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":159979.24},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41766.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":102885.44},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":124455.46},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41365.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":95400.81},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":141573.26},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":176405.93},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42971.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41164.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":81939.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42570.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":89156.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42931.59,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Diabetes With Cc","code_information":[{"code":"638","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8419.83,"maximum":33627.22,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30495.89},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8543.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19612.44},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":23724.21},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8460.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":18185.69},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26987.27},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":33627.22},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8789.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8419.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16759.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8707.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":18236.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8781.27,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":4022.63,"10th_percentile":4022.63,"90th_percentile":4022.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7684.26,"10th_percentile":7684.26,"90th_percentile":7684.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":3967.99,"10th_percentile":3967.99,"90th_percentile":3967.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":4214.18,"10th_percentile":4214.18,"90th_percentile":4214.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":6193.09,"10th_percentile":6084.57,"90th_percentile":7741.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disorders Without Cc/Mcc","code_information":[{"code":"624","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11480.73,"maximum":46973.79,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42599.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11648.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27396.58},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":33140.3},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11536.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":25403.55},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":37698.46},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":46973.79},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11984.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11480.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22852.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11872.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":24865.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11973.56,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With Mcc Or Insertion Of","code_information":[{"code":"616","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":30717.75,"maximum":130854.22,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":118669.25},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31167.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":76318.26},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":92318.45},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30867.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":70766.32},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":105016.08},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":130854.22},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32066.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30717.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":61144.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31766.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":66530.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32036.37,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cellulitis With Mcc","code_information":[{"code":"602","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12938.45,"maximum":53330.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48364.0},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13127.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31103.73},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":37624.65},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13001.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":28841.02},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42799.61},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":53330.02},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13506.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12938.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25754.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13380.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":28022.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13493.86,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":10209.74,"10th_percentile":10209.74,"90th_percentile":10209.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Ulcers Without Cc/Mcc","code_information":[{"code":"594","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8166.84,"maximum":32524.07,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29495.47},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8286.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18969.05},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":22945.93},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8206.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":17589.11},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26101.95},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":32524.07},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8525.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8166.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16256.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8445.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17688.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8517.42,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Skin, Subcutaneous Tissue And Breast Procedures With Cc","code_information":[{"code":"580","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15577.68,"maximum":64838.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":58800.38},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15805.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":37815.55},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":45743.62},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15653.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":35064.58},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":52035.26},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":64838.02},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16261.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15577.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31007.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16109.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":33738.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16246.38,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Debridement Without Cc/Mcc","code_information":[{"code":"572","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10572.01,"maximum":43011.47,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39006.3},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10726.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25085.63},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":30344.85},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10623.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":23260.72},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34518.53},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":43011.47},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11036.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10572.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21043.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10933.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":22897.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11025.84,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Aftercare, Musculoskeletal System And Connective Tissue Without Cc/Mcc","code_information":[{"code":"561","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7625.57,"maximum":30163.94,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27355.11},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7737.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17592.55},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":21280.84},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7662.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":16312.74},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24207.84},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":30163.94},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7960.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7625.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15178.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7885.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16515.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7952.91,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Bone Diseases And Arthropathies With Mcc","code_information":[{"code":"553","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11862.8,"maximum":48639.77,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44110.5},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12036.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28368.23},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":34315.65},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11920.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":26304.52},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39035.48},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":48639.77},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12383.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11862.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23613.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12267.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":25693.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12372.03,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Connective Tissue Disorders With Mcc","code_information":[{"code":"545","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":22063.45,"maximum":93118.35,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":84447.29},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22386.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":54309.52},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":65695.56},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22171.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":50358.66},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":74731.43},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":93118.35},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23032.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22063.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":43918.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22816.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":47786.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23010.57,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Sprains, Strains, And Dislocations Of Hip, Pelvis And Thigh With Cc/Mcc","code_information":[{"code":"537","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8919.81,"maximum":35807.24,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32472.92},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9050.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20883.9},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":25262.23},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8963.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":19364.66},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28736.84},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":35807.24},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9311.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8919.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17755.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9224.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":19319.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9302.71,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Back And Neck Procedures Except Spinal Fusion With Cc","code_information":[{"code":"519","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17920.03,"maximum":75051.5,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":68062.81},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18182.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":43772.38},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":52949.29},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18007.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":40588.06},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":60232.02},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":75051.5},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18706.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17920.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":35670.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18531.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":38812.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18689.28,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc","code_information":[{"code":"511","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18601.57,"maximum":78023.25,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":70757.82},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18873.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45505.59},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":55045.88},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18692.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":42195.18},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":62616.97},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":78023.25},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19418.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18601.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37027.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19236.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":40288.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19400.07,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Digestive System Diagnoses With Cc","code_information":[{"code":"394","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8759.74,"maximum":35109.34,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31840.0},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8887.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20476.86},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":24769.85},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8802.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":18987.22},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28176.73},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":35109.34},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9144.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8759.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17436.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9058.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":18972.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9135.77,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7974.7,"10th_percentile":7974.7,"90th_percentile":7974.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7954.41,"10th_percentile":7954.41,"90th_percentile":7954.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"1 through 10","median_amount":37709.25,"10th_percentile":37709.25,"90th_percentile":37709.25},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20448.82,"10th_percentile":20448.82,"90th_percentile":20448.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":4986.97,"10th_percentile":4986.97,"90th_percentile":4986.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":5956.92,"10th_percentile":5956.92,"90th_percentile":5956.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inflammatory Bowel Disease With Cc","code_information":[{"code":"386","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9109.11,"maximum":36632.73,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33221.54},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9242.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21365.35},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":25844.61},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9153.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":19811.08},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29399.32},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":36632.73},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9509.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9109.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18132.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9420.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":19729.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9500.14,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":3350.86,"10th_percentile":3350.86,"90th_percentile":3350.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":3198.55,"10th_percentile":3198.55,"90th_percentile":3198.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Gastrointestinal Hemorrhage With Cc","code_information":[{"code":"378","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9146.98,"maximum":36797.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33371.26},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9280.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21461.64},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":25961.09},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9191.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":19900.36},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29531.82},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":36797.83},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9548.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9146.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18207.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9459.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":19811.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9539.63,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5961.05,"10th_percentile":5961.05,"90th_percentile":5961.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":7613.64,"10th_percentile":6753.12,"90th_percentile":8414.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Esophageal Disorders Without Cc/Mcc","code_information":[{"code":"370","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6738.37,"maximum":26295.42,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23846.82},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6836.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15336.31},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":18551.58},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6771.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":14220.63},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21103.19},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":26295.42},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7034.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6738.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13412.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6968.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14594.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7027.63,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hernia Procedures Except Inguinal And Femoral Without Cc/Mcc","code_information":[{"code":"355","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12281.87,"maximum":50467.09,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45767.66},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12461.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29433.98},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":35604.84},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12341.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":27292.74},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40501.99},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":50467.09},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12821.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12281.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24447.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12701.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":26600.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12809.09,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Anal And Stomal Procedures With Mcc","code_information":[{"code":"347","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":20462.02,"maximum":86135.5,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":78114.68},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20761.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":50236.91},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":60769.12},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20561.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":46582.32},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":69127.4},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":86135.5},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21360.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20462.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":40730.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21160.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":44317.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21340.39,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Rectal Resection With Cc","code_information":[{"code":"333","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":20863.02,"maximum":87884.03,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":79700.38},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21168.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":51256.7},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":62002.72},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20964.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":47527.92},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":70530.67},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":87884.03},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21778.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20863.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":41528.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21575.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":45186.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21758.61,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Coronary Intravascular Lithotripsy Without Intraluminal Device","code_information":[{"code":"325","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":28334.11,"maximum":120460.63,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":109243.49},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28748.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":70256.39},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":84985.71},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28472.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":65145.44},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":96674.78},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":120460.63},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29578.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28334.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":56400.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29301.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":61367.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29550.4,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Concomitant Left Atrial Appendage Closure And Cardiac Ablation","code_information":[{"code":"317","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":58246.8,"maximum":250890.85,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":227528.22},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":59099.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":146327.37},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":177005.03},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":58530.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":135682.46},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":201350.57},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":250890.85},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":60803.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":58246.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":115942.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":60235.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":126154.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":60747.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Arrhythmia And Conduction Disorders With Cc","code_information":[{"code":"309","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7038.7,"maximum":27604.94,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25034.4},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7141.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16100.06},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":19475.45},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7073.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":14928.82},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22154.13},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":27604.94},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7347.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7038.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14010.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7279.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":15244.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7340.84,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"1 through 10","median_amount":15139.25,"10th_percentile":15139.25,"90th_percentile":15139.25},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16187.82,"10th_percentile":16187.82,"90th_percentile":16187.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Peripheral Vascular Disorders Without Cc/Mcc","code_information":[{"code":"301","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6901.01,"maximum":27004.58,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24489.95},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7002.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15749.91},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":19051.9},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6934.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":14604.15},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21672.33},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":27004.58},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7203.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6901.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13736.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7136.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14946.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7197.25,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Heart Failure And Shock With Mcc","code_information":[{"code":"291","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11755.23,"maximum":48170.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43685.15},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11927.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28094.68},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":33984.75},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11812.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":26050.87},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":38659.07},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":48170.74},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12271.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11755.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23399.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12156.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":25460.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12259.85,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10679.64,"10th_percentile":10679.64,"90th_percentile":10679.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":28164.69,"10th_percentile":28164.69,"90th_percentile":28164.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9735.51,"10th_percentile":9735.51,"90th_percentile":9735.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":27050.74,"10th_percentile":27050.74,"90th_percentile":27050.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":5015.03,"10th_percentile":5015.03,"90th_percentile":5015.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":1120.0,"10th_percentile":1120.0,"90th_percentile":1120.0},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":9233.92,"10th_percentile":9144.02,"90th_percentile":10782.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Myocardial Infarction, Expired With Mcc","code_information":[{"code":"283","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17753.09,"maximum":74323.58,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":67402.66},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18012.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":43347.83},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":52435.74},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17839.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":40194.39},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":59647.83},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":74323.58},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18532.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17753.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":35338.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18359.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":38450.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18515.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc","code_information":[{"code":"275","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":62066.67,"maximum":267546.87,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":242633.25},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":62974.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":156041.67},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":188755.95},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":62369.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":144690.08},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":214717.74},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":267546.87},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":64791.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":62066.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":123545.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":64186.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":134427.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":64731.0,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc","code_information":[{"code":"267","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":41675.68,"maximum":178634.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":162000.5},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42285.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":104185.35},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":126027.9},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41878.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":96606.15},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":143361.97},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":178634.74},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43505.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41675.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":82956.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43098.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":90263.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43464.68,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Pacemaker Device Replacement Without Mcc","code_information":[{"code":"259","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18108.48,"maximum":75873.24,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":68808.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18373.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":44251.64},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":53529.03},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18196.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":41032.45},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":60891.5},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":75873.24},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18903.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18108.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":36045.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18726.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":39220.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18885.82,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc","code_information":[{"code":"251","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13568.36,"maximum":56076.63,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50854.85},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13766.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32705.64},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":39562.4},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13634.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":30326.39},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45003.88},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":56076.63},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14164.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13568.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27008.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14031.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29387.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14150.8,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12664.47,"10th_percentile":12664.47,"90th_percentile":12664.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc","code_information":[{"code":"239","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":43060.26,"maximum":184672.03,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":167475.61},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43690.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":107706.48},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":130287.24},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43270.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":99871.14},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":148207.15},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":184672.03},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44950.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43060.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":85713.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44530.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":93262.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44908.7,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Cardiothoracic Procedures With Mcc","code_information":[{"code":"228","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":43281.41,"maximum":185636.34,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":168350.13},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43914.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":108268.9},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":130967.57},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43492.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":100392.64},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":148981.06},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":185636.34},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45181.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43281.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":86153.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44759.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":93741.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45139.35,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Endovascular Abdominal Aorta With Iliac Branch Procedures","code_information":[{"code":"213","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":49817.1,"maximum":214134.3,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":194194.39},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50546.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":124889.8},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":151073.06},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50060.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":115804.41},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":171851.88},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":214134.3},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52004.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49817.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":99162.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51518.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":107896.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51955.59,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Bronchitis And Asthma Without Cc/Mcc","code_information":[{"code":"203","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6473.33,"maximum":25139.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22798.76},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6568.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14662.28},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":17736.24},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6504.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":13595.64},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20175.71},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":25139.74},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6757.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6473.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12885.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6694.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14020.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6751.21,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":3472.85,"10th_percentile":3472.85,"90th_percentile":3472.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Simple Pneumonia And Pleurisy Without Cc/Mcc","code_information":[{"code":"195","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6116.22,"maximum":23582.58,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21386.6},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6205.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13754.09},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":16637.65},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6146.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":12753.52},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18926.02},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":23582.58},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6384.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6116.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12174.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6325.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":13246.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6378.77,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":1814.31,"10th_percentile":1814.31,"90th_percentile":1814.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pleural Effusion With Cc","code_information":[{"code":"187","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9219.26,"maximum":37113.01,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33657.09},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9354.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21645.46},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":26183.46},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9264.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":20070.82},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29784.77},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":37113.01},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9624.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9219.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18351.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9534.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":19967.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9615.01,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8395.43,"10th_percentile":8395.43,"90th_percentile":8395.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Respiratory Infections And Inflammations Without Cc/Mcc","code_information":[{"code":"179","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7204.78,"maximum":28329.11,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25691.14},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7310.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16522.42},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":19986.36},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7239.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":15320.46},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22735.32},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":28329.11},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7521.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7204.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14341.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7450.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":15604.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7514.05,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ear, Nose, Mouth And Throat Malignancy With Cc","code_information":[{"code":"147","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11649.38,"maximum":47709.22,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43266.6},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11819.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27825.51},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":33659.15},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11706.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":25801.28},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":38288.68},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":47709.22},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12160.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11649.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23188.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12047.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":25230.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12149.45,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Salivary Gland Procedures","code_information":[{"code":"139","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11341.32,"maximum":46365.94,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42048.4},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11507.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27042.06},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":32711.45},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11396.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":25074.82},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":37210.63},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":46365.94},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11839.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11341.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22575.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11728.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":24563.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11828.16,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Major Eye Infections Without Cc/Mcc","code_information":[{"code":"122","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7469.82,"maximum":29484.79,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26739.2},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7579.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17196.45},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":20801.7},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7506.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":15945.45},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23662.8},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":29484.79},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7797.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7469.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14868.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7724.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16178.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7790.48,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Headaches With Mcc","code_information":[{"code":"102","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10353.43,"maximum":42058.41,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38141.99},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10504.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24529.78},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":29672.46},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10403.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":22745.3},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33753.66},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":42058.41},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10807.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10353.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20608.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10706.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":22424.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10797.87,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Bacterial And Tuberculous Infections Of Nervous System With Mcc","code_information":[{"code":"094","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":30993.12,"maximum":132054.93,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":119758.14},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31446.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":77018.55},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":93165.56},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31144.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":71415.66},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":105979.69},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":132054.93},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32353.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30993.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":61692.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32051.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":67126.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32323.56,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Traumatic Stupor And Coma <1 Hour With Cc","code_information":[{"code":"086","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11917.87,"maximum":48879.91,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44328.28},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12092.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28508.29},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":34485.07},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11976.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":26434.39},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39228.21},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":48879.91},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12441.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11917.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23722.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12324.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":25812.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12429.47,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Viral Meningitis With Cc/Mcc","code_information":[{"code":"075","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17208.38,"maximum":71948.44,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":65248.69},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17460.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":41962.57},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":50760.06},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17292.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":38909.91},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":57741.68},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":71948.44},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17963.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17208.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34253.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17795.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":37270.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17947.08,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Precerebral Occlusion Without Infarction With Mcc","code_information":[{"code":"067","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13346.34,"maximum":55108.56,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49976.92},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13541.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32141.03},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":38879.43},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13411.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":29802.86},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":44226.96},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":55108.56},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13932.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13346.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26566.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13802.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":28906.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13919.26,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Multiple Sclerosis And Cerebellar Ataxia With Cc","code_information":[{"code":"059","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11386.07,"maximum":46561.05,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42225.35},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11552.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27155.86},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":32849.1},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11441.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":25180.34},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":37367.22},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":46561.05},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11885.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11386.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22664.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11774.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":24660.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11874.84,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Foot Procedures With Mcc","code_information":[{"code":"503","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":24725.92,"maximum":104727.65,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":94975.55},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25087.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":61080.43},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":73886.0},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24846.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":56637.0},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":84048.39},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":104727.65},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25811.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24725.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":49217.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25570.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":53552.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25787.33,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur With Mcc","code_information":[{"code":"495","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":31907.86,"maximum":136043.52,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":123375.32},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32374.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":79344.82},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":95979.53},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32063.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":73572.7},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":109180.7},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":136043.52},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33308.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31907.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":63513.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32997.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":69107.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33277.56,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Knee Procedures With Principal Diagnosis Of Infection With Mcc","code_information":[{"code":"485","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":28477.81,"maximum":121087.25,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":109811.76},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28894.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":70621.86},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":85427.79},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28616.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":65484.31},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":97177.66},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":121087.25},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29728.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28477.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":56686.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29450.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":61678.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29700.27,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Amputation For Musculoskeletal System And Connective Tissue Disorders Without Cc/Mcc","code_information":[{"code":"476","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10863.73,"maximum":44283.46,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40159.85},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11022.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25827.5},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":31242.25},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10916.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":23948.62},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35539.36},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":44283.46},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11340.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10863.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21624.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11234.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":23529.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11330.07,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Revision Of Hip Or Knee Replacement Without Cc/Mcc","code_information":[{"code":"468","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":24355.04,"maximum":103110.46,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":93508.94},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24711.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":60137.23},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":72745.06},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24473.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":55762.42},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":82750.52},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":103110.46},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25424.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24355.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":48479.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25186.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":52749.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25400.52,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Or Infection Without Cc/Mcc","code_information":[{"code":"458","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":36614.07,"maximum":156564.3,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":141985.23},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37149.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":91313.18},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":110457.07},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36792.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":84670.4},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":125649.5},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":156564.3},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38221.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36614.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":72881.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37864.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":79300.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38185.79,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Disorders Of The Biliary Tract With Cc","code_information":[{"code":"445","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10125.4,"maximum":41064.08,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37240.24},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10273.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23949.85},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":28970.96},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10174.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":22207.56},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32955.67},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":41064.08},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10569.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10125.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20154.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10471.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":21930.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10560.05,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignancy Of Hepatobiliary System Or Pancreas Without Cc/Mcc","code_information":[{"code":"437","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8050.67,"maximum":32017.52,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29036.09},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8168.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18673.62},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":22588.56},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8089.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":17315.16},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25695.42},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":32017.52},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8404.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8050.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16025.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8325.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17436.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8396.26,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Without Cc/Mcc","code_information":[{"code":"428","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":49086.51,"maximum":210948.68,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":191305.42},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49804.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":123031.85},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":148825.58},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49325.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":114081.62},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":169295.29},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":210948.68},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51241.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49086.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":97708.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50762.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":106314.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51193.64,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hepatobiliary Diagnostic Procedures With Mcc","code_information":[{"code":"420","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":30026.75,"maximum":127841.21,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":115936.8},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30466.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":74560.98},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":90192.75},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30173.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":69136.87},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":102598.0},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":127841.21},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31345.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30026.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":59769.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31052.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":65033.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31315.7,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cholecystectomy With C.D.E. With Cc","code_information":[{"code":"412","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18800.34,"maximum":78890.01,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":71543.87},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19075.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46011.11},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":55657.38},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18892.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":42663.93},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":63312.58},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":78890.01},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19625.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18800.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37422.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19442.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":40718.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19607.38,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical","code_information":[{"code":"402","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":35305.21,"maximum":150857.2,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":136809.57},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35821.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":87984.62},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":106430.68},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35477.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":81583.99},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":121069.32},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":150857.2},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36855.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35305.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":70276.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36510.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":76465.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36820.75,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc","code_information":[{"code":"391","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11621.85,"maximum":47589.15,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43157.71},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11791.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27755.48},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":33574.44},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11678.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":25736.34},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":38192.32},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":47589.15},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12132.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11621.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23133.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12018.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":25171.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12120.74,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":38192.32,"10th_percentile":38192.32,"90th_percentile":38192.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":10660.7,"10th_percentile":10660.7,"90th_percentile":10660.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Uncomplicated Peptic Ulcer With Mcc","code_information":[{"code":"383","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12589.08,"maximum":51806.63,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46982.46},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12773.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30215.24},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":36549.89},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12650.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":28017.16},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":41577.02},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":51806.63},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13141.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12589.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25059.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13018.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":27266.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13129.49,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Digestive Malignancy With Cc","code_information":[{"code":"375","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11116.72,"maximum":45386.61,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41160.27},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11279.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26470.89},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":32020.53},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11170.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":24545.2},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36424.68},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":45386.61},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11604.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11116.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22128.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11496.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":24077.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11593.93,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc","code_information":[{"code":"360","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21483.47,"maximum":90589.36,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":82153.8},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21797.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":52834.54},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":63911.35},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21588.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":48990.98},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":72701.82},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":90589.36},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22426.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21483.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":42763.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22217.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":46530.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22405.68,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inguinal And Femoral Hernia Procedures Without Cc/Mcc","code_information":[{"code":"352","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10757.03,"maximum":43818.19,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39737.9},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10914.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25556.14},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":30914.0},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10809.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":23697.0},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35165.96},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":43818.19},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11229.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10757.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21412.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11124.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":23298.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11218.79,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Minor Small And Large Bowel Procedures With Mcc","code_information":[{"code":"344","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":22933.45,"maximum":96911.82,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":87887.52},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23269.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":56522.0},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":68371.88},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23045.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":52410.18},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":77775.86},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":96911.82},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23940.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22933.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":45649.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23716.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":49670.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23917.91,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Small And Large Bowel Procedures With Cc","code_information":[{"code":"330","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21336.32,"maximum":89947.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":81571.92},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21648.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":52460.32},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":63458.68},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21440.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":48643.98},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":72186.88},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":89947.74},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22273.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21336.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":42470.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22064.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":46211.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22252.22,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":48868.79,"10th_percentile":48868.79,"90th_percentile":48868.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":17720.71,"10th_percentile":17720.71,"90th_percentile":17720.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc","code_information":[{"code":"322","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15878.87,"maximum":66151.29,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59991.36},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16111.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":38581.49},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":46670.14},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15956.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":35774.8},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":53089.22},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":66151.29},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16575.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15878.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31607.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16421.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":34391.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16560.5,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"1 through 10","median_amount":25052.23,"10th_percentile":25052.23,"90th_percentile":25052.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14421.27,"10th_percentile":14421.27,"90th_percentile":14421.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":54059.58,"10th_percentile":54059.58,"90th_percentile":54059.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":35437.17,"10th_percentile":35437.17,"90th_percentile":35437.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":17164.26,"10th_percentile":17164.26,"90th_percentile":26378.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Circulatory System Diagnoses With Mcc","code_information":[{"code":"314","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18651.47,"maximum":78240.87,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":70955.19},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18924.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45632.52},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":55199.41},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18742.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":42312.88},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":62791.63},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":78240.87},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19470.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18651.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37126.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19288.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":40396.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19452.12,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Congenital And Valvular Disorders With Mcc","code_information":[{"code":"306","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14267.96,"maximum":59127.17,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53621.32},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14476.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34484.81},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":41714.58},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14337.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":31976.13},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":47452.07},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":59127.17},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14894.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14267.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28400.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14755.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":30902.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14880.44,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Arrest, Unexplained Without Cc/Mcc","code_information":[{"code":"298","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4624.06,"maximum":17076.26,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15486.14},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4691.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9959.41},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":12047.41},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4646.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":9234.89},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13704.43},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":17076.26},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4827.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4624.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9204.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4781.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":10015.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4822.56,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute And Subacute Endocarditis With Mcc","code_information":[{"code":"288","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":23995.33,"maximum":101542.04,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":92086.57},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24346.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":59222.48},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":71638.53},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24112.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":54914.21},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":81491.8},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":101542.04},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25048.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23995.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":47763.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24814.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":51970.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25025.38,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Myocardial Infarction, Discharged Alive With Mcc","code_information":[{"code":"280","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14511.49,"maximum":60189.04,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":54584.31},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14723.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35104.12},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":42463.74},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14582.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":32550.4},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":48304.26},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":60189.04},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15148.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14511.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28885.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15007.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":31429.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15134.42,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13176.53,"10th_percentile":13174.83,"90th_percentile":13184.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":48304.26,"10th_percentile":48304.26,"90th_percentile":48304.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14393.49,"10th_percentile":14393.49,"90th_percentile":14393.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13824.89,"10th_percentile":13824.89,"90th_percentile":13824.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":32657.51,"10th_percentile":28094.53,"90th_percentile":33827.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":3074.57,"10th_percentile":3074.57,"90th_percentile":3966.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":28197.42,"10th_percentile":28197.42,"90th_percentile":168714.31},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":11629.15,"10th_percentile":8252.7,"90th_percentile":13295.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Major Cardiovascular Procedures Without Cc/Mcc","code_information":[{"code":"272","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":22677.01,"maximum":95793.67,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":86873.48},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23008.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":55869.85},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":67583.02},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22787.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":51805.48},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":76878.49},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":95793.67},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23672.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22677.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":45139.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23451.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":49115.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23650.46,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20868.21,"10th_percentile":20868.21,"90th_percentile":20868.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Circulatory System O.R. Procedures","code_information":[{"code":"264","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":29454.5,"maximum":125345.99,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":113673.94},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29885.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":73105.69},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":88432.36},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29598.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":67787.46},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":100595.49},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":125345.99},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30747.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29454.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":58630.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30460.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":63794.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30718.89,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Upper Limb And Toe Amputation For Circulatory System Disorders With Cc","code_information":[{"code":"256","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15318.67,"maximum":63708.6,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57776.14},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15542.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":37156.84},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":44946.81},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15393.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":34453.79},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":51128.86},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":63708.6},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15991.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15318.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30492.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15841.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":33177.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15976.25,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":12379.73,"10th_percentile":12379.73,"90th_percentile":12379.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Permanent Cardiac Pacemaker Implant Without Cc/Mcc","code_information":[{"code":"244","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16261.8,"maximum":67821.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61505.61},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16499.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39555.33},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":47848.14},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16341.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":36677.79},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":54429.25},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":67821.02},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16975.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16261.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32369.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16817.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":35220.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16959.87,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14749.07,"10th_percentile":14749.07,"90th_percentile":14749.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14702.73,"10th_percentile":14702.73,"90th_percentile":14702.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc","code_information":[{"code":"234","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":47715.7,"maximum":204971.43,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":185884.76},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48413.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":119545.73},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":144608.59},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47948.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":110849.11},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":164498.29},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":204971.43},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49810.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47715.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":94979.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49345.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":103345.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49763.98,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Respiratory System Diagnosis With Ventilator Support <=96 Hours","code_information":[{"code":"208","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":24361.06,"maximum":103136.72,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":93532.76},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24717.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":60152.55},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":72763.59},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24479.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":55776.62},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":82771.6},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":103136.72},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25430.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24361.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":48491.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25192.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":52762.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25406.81,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pneumothorax With Cc","code_information":[{"code":"200","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10167.56,"maximum":41247.93,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37406.98},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10316.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24057.08},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":29100.67},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10217.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":22307.0},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33103.22},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":41247.93},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10613.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10167.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20238.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10514.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":22021.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10604.02,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Chronic Obstructive Pulmonary Disease Without Cc/Mcc","code_information":[{"code":"192","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6232.38,"maximum":24089.12,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21845.98},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6323.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14049.53},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":16995.02},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6262.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":13027.46},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19332.55},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":24089.12},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6506.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6232.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12405.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6445.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":13498.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6499.92,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Chest Trauma With Cc","code_information":[{"code":"184","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9864.66,"maximum":39927.16,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36209.19},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10009.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23286.76},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":28168.86},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9912.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":21592.72},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32043.24},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":39927.16},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10297.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9864.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19635.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10201.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":21365.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10288.12,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":9058.71,"10th_percentile":9058.71,"90th_percentile":9058.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Soft Tissue Procedures Without Cc/Mcc","code_information":[{"code":"502","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12289.62,"maximum":50500.86,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45798.29},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12469.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29453.68},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":35628.66},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12349.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":27311.0},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40529.09},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":50500.86},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12829.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12289.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24462.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12709.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":26617.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12817.17,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/Mcc","code_information":[{"code":"494","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17974.25,"maximum":75287.89,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":68277.18},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18237.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":43910.25},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":53116.07},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18061.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":40715.9},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":60421.73},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":75287.89},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18763.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17974.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":35778.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18588.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":38929.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18745.82,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":14786.08,"10th_percentile":14786.08,"90th_percentile":14786.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Joint Or Limb Reattachment Procedures Of Upper Extremities","code_information":[{"code":"483","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":24560.7,"maximum":104007.23,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":94322.21},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24920.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":60660.26},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":73377.74},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24680.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":56247.39},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":83470.22},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":104007.23},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25638.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24560.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":48888.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25399.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":53194.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25615.01,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc","code_information":[{"code":"475","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":20290.78,"maximum":85388.82,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":77437.52},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20587.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":49801.42},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":60242.33},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20389.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":46178.5},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":68528.15},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":85388.82},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21181.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20290.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":40389.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20983.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":43946.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21161.8,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":92303.8,"10th_percentile":92303.8,"90th_percentile":92303.8},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Revision Of Hip Or Knee Replacement With Cc","code_information":[{"code":"467","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":31055.08,"maximum":132325.09,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":120003.14},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31509.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":77176.11},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":93356.16},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31206.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":71561.77},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":106196.51},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":132325.09},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32418.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31055.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":61816.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32115.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":67260.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32388.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Or Infection With Cc","code_information":[{"code":"457","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":52021.76,"maximum":223747.44,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":202912.37},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52783.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":130496.48},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":157855.18},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52275.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":121003.23},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":179566.83},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":223747.44},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54305.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52021.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":103551.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53798.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":112671.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54254.89,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Disorders Of The Biliary Tract With Mcc","code_information":[{"code":"444","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15086.32,"maximum":62695.51,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56857.39},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15307.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36565.98},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":44232.06},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15159.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":33905.9},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":50315.81},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":62695.51},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15748.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15086.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30029.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15601.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":32674.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15733.93,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13694.59,"10th_percentile":13694.59,"90th_percentile":13694.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignancy Of Hepatobiliary System Or Pancreas With Cc","code_information":[{"code":"436","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10441.21,"maximum":42441.13,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38489.07},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10594.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24752.99},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":29942.48},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10492.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":22952.28},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34060.81},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":42441.13},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10899.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10441.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20783.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10797.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":22614.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10889.42,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical With Cc","code_information":[{"code":"427","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":62825.65,"maximum":270856.31,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":245634.52},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":63745.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":157971.84},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":191090.78},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":63132.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":146479.83},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":217373.7},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":270856.31},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":65583.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":62825.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":125056.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":64970.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":136071.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":65522.56,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Laparoscopic Cholecystectomy Without C.D.E. Without Cc/Mcc","code_information":[{"code":"419","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12460.86,"maximum":51247.55,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46475.44},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12643.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29889.17},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":36155.46},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12521.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":27714.81},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":41128.34},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":51247.55},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13007.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12460.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24803.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12886.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":26988.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12995.77,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cholecystectomy With C.D.E. With Mcc","code_information":[{"code":"411","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":29133.52,"maximum":123946.42,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":112404.69},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29559.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":72289.42},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":87444.96},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29275.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":67030.56},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":99472.27},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":123946.42},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30412.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29133.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":57991.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30128.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":63098.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30384.13,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Appendix Procedures Without Cc/Mcc","code_information":[{"code":"399","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10558.24,"maximum":42951.43,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38951.85},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10712.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25050.61},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":30302.5},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10609.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":23228.25},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34470.35},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":42951.43},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11021.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10558.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21016.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10918.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":22867.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11011.47,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23476.83,"10th_percentile":23476.83,"90th_percentile":23476.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":4416.96,"10th_percentile":4416.96,"90th_percentile":4416.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Gastrointestinal Obstruction Without Cc/Mcc","code_information":[{"code":"390","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5389.07,"maximum":20411.97,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18511.23},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5467.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11904.9},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":14400.77},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5415.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":11038.85},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16381.47},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":20411.97},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5625.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5389.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10727.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5573.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":11671.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5620.41,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Complicated Peptic Ulcer Without Cc/Mcc","code_information":[{"code":"382","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7597.18,"maximum":30040.11,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27242.82},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7708.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17520.33},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":21193.48},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7634.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":16245.78},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24108.47},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":30040.11},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7930.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7597.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15122.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7856.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16454.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7923.3,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Digestive Malignancy With Mcc","code_information":[{"code":"374","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19111.85,"maximum":80248.3,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":72775.68},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19391.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46803.31},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":56615.67},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19205.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":43398.5},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":64402.67},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":80248.3},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19950.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19111.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":38042.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19764.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":41393.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19932.26,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc","code_information":[{"code":"359","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":30297.82,"maximum":129023.15,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":117008.68},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30741.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":75250.32},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":91026.62},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30445.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":69776.07},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":103546.56},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":129023.15},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31627.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30297.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":60308.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31332.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":65620.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31598.41,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inguinal And Femoral Hernia Procedures With Cc","code_information":[{"code":"351","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13826.51,"maximum":57202.29,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51875.69},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14028.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33362.16},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":40356.56},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13893.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":30935.15},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45907.27},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":57202.29},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14433.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13826.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27522.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14298.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29946.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14420.04,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12560.99,"10th_percentile":12560.99,"90th_percentile":12560.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Peritoneal Adhesiolysis Without Cc/Mcc","code_information":[{"code":"337","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13916.87,"maximum":57596.27,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52232.98},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14120.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33591.94},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":40634.52},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13984.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":31148.22},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46223.46},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":57596.27},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14527.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13916.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27702.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14392.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":30141.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14514.27,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Small And Large Bowel Procedures With Mcc","code_information":[{"code":"329","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":40261.84,"maximum":172469.87,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":156409.7},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40851.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":100589.81},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":121678.55},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40458.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":93272.18},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":138414.4},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":172469.87},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42029.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40261.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":80142.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41636.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":87201.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41990.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15911.52,"10th_percentile":15911.52,"90th_percentile":15911.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":603.21,"10th_percentile":603.21,"90th_percentile":603.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":16054.42,"10th_percentile":16054.42,"90th_percentile":16054.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ Arteries/Intraluminal","code_information":[{"code":"321","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":24120.98,"maximum":102089.86,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":92583.38},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24473.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":59541.99},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":72025.02},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24238.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":55210.47},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":81931.45},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":102089.86},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25179.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24120.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":48013.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24944.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":52242.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25156.41,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":20389.94,"10th_percentile":20389.94,"90th_percentile":22055.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Chest Pain","code_information":[{"code":"313","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6903.59,"maximum":27015.84,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24500.16},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7004.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15756.48},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":19059.84},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6937.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":14610.24},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21681.36},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":27015.84},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7206.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6903.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13741.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7139.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14952.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7199.94,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":300.0,"10th_percentile":300.0,"90th_percentile":300.0},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hypertension Without Mcc","code_information":[{"code":"305","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7205.64,"maximum":28332.86,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25694.54},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7311.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16524.61},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":19989.01},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7240.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":15322.49},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22738.33},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":28332.86},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7521.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7205.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14343.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7451.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":15606.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7514.95,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15840.94,"10th_percentile":15840.94,"90th_percentile":15840.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Arrest, Unexplained With Cc","code_information":[{"code":"297","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6163.54,"maximum":23788.95,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21573.75},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6253.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13874.46},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":16783.25},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6193.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":12865.13},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19091.64},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":23788.95},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6434.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6163.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12268.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6374.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":13349.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6428.12,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Circulatory Disorders Except Ami, With Cardiac Catheterization Without Mcc","code_information":[{"code":"287","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9916.29,"maximum":40152.29,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36413.36},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10061.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23418.07},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":28327.69},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9964.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":21714.47},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32223.92},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":40152.29},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10351.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9916.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19738.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10254.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":21477.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10341.97,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"1 through 10","median_amount":34679.8,"10th_percentile":34679.8,"90th_percentile":34679.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":22529.94,"10th_percentile":22529.94,"90th_percentile":22529.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":27524.71,"10th_percentile":27524.71,"90th_percentile":27524.71},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":7557.4,"10th_percentile":7557.4,"90th_percentile":7557.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures Without Mcc","code_information":[{"code":"279","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":31741.78,"maximum":135319.34,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":122718.58},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32206.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":78922.46},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":95468.62},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31896.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":73181.07},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":108599.52},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":135319.34},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33135.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31741.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":63183.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32825.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":68748.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33104.35,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Major Cardiovascular Procedures With Cc","code_information":[{"code":"271","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":31310.65,"maximum":133439.49,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":121013.78},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31768.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":77826.07},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":94142.37},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31463.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":72164.44},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":107090.86},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":133439.49},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32685.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31310.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":62325.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32379.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":67814.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32654.72,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"1 through 10","median_amount":81947.77,"10th_percentile":81947.77,"90th_percentile":81947.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":28390.34,"10th_percentile":28390.34,"90th_percentile":28390.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":9982.64,"10th_percentile":9982.64,"90th_percentile":9982.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":26980.67,"10th_percentile":26980.67,"90th_percentile":26980.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Vein Ligation And Stripping","code_information":[{"code":"263","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":27017.49,"maximum":114719.76,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":104037.21},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27412.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":66908.14},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":80935.49},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27149.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":62040.76},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":92067.49},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":114719.76},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28203.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27017.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":53779.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27940.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":58515.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28177.27,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc","code_information":[{"code":"255","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":23919.6,"maximum":101211.84,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":91787.13},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24269.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":59029.9},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":71405.57},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24036.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":54735.64},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":81226.81},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":101211.84},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24969.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23919.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":47612.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24736.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":51806.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24946.4,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Permanent Cardiac Pacemaker Implant With Cc","code_information":[{"code":"243","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19044.74,"maximum":79955.63,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":72510.27},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19323.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46632.62},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":56409.18},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19137.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":43240.22},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":64167.79},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":79955.63},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19880.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19044.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37909.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19695.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":41248.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19862.27,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":15783.61,"10th_percentile":15783.61,"90th_percentile":15783.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc","code_information":[{"code":"233","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":66496.65,"maximum":286863.19,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":260150.87},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":67469.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":167307.56},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":202383.73},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":66821.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":155136.4},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":230219.91},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":286863.19},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":69416.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":66496.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":132364.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":68767.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":144022.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":69351.14,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization Without Cc/Mcc","code_information":[{"code":"218","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":57289.89,"maximum":246718.41,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":223744.31},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":58128.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":143893.87},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":174061.34},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57569.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":133425.99},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":198002.01},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":246718.41},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":59805.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57289.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":114037.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":59246.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":124081.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":59749.17,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Respiratory System Diagnosis With Ventilator Support >96 Hours","code_information":[{"code":"207","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":56080.0,"maximum":241442.81,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":218959.97},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":56900.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":140816.97},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":170339.38},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":56353.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":130572.93},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":193768.12},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":241442.81},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":58542.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":56080.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":111629.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57994.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":121461.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":58487.34,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pneumothorax With Mcc","code_information":[{"code":"199","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15888.33,"maximum":66192.56,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":60028.79},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16120.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":38605.56},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":46699.26},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15965.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":35797.12},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":53122.34},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":66192.56},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16585.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15888.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31626.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16430.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":34411.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16570.37,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Chronic Obstructive Pulmonary Disease With Cc","code_information":[{"code":"191","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7962.04,"maximum":31631.05,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28685.6},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8078.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18448.21},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":22315.9},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8000.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":17106.16},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25385.26},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":31631.05},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8311.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7962.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15848.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8233.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17244.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8303.82,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":20147.56,"10th_percentile":20147.56,"90th_percentile":20147.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":5666.65,"10th_percentile":5666.65,"90th_percentile":5666.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Chest Trauma With Mcc","code_information":[{"code":"183","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13872.99,"maximum":57404.91,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52059.44},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14076.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33480.33},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":40499.51},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13940.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":31044.73},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46069.88},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":57404.91},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14482.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13872.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27614.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14346.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":30046.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14468.51,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":5266.83,"10th_percentile":5266.83,"90th_percentile":5266.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc","code_information":[{"code":"282","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6930.27,"maximum":27132.16,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24605.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7031.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15824.32},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":19141.9},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6964.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":14673.15},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21774.71},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":27132.16},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7234.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6930.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13794.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7166.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":15009.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7227.77,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"1 through 10","median_amount":20312.82,"10th_percentile":20312.82,"90th_percentile":20312.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6327.69,"10th_percentile":6327.69,"90th_percentile":6327.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":4732.18,"10th_percentile":4732.18,"90th_percentile":4732.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute And Subacute Endocarditis Without Cc/Mcc","code_information":[{"code":"290","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8708.11,"maximum":34884.2,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31635.83},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8835.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20345.55},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":24611.02},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8750.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":18865.47},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27996.06},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":34884.2},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9090.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8708.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17333.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9005.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":18860.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9081.92,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Peripheral Vascular Disorders With Cc","code_information":[{"code":"300","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9893.92,"maximum":40054.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36324.89},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10038.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23361.17},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":28258.86},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9942.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":21661.71},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32145.63},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":40054.74},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10328.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9893.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19694.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10231.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":21428.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10318.63,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Endocrine Disorders With Cc","code_information":[{"code":"644","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9528.2,"maximum":38460.05,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34878.7},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9667.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22431.1},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":27133.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9574.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":20799.3},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30865.83},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":38460.05},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9946.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9528.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18966.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9853.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":20636.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9937.21,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":6652.13,"10th_percentile":6652.13,"90th_percentile":6652.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Endocrine, Nutritional And Metabolic O.R. Procedures Without Cc/Mcc","code_information":[{"code":"630","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13267.17,"maximum":54763.36,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49663.87},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13461.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31939.7},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":38635.88},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13331.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":29616.17},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":43949.92},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":54763.36},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13849.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13267.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26408.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13720.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":28734.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13836.69,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disorders With Mcc","code_information":[{"code":"622","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":31335.61,"maximum":133548.3,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":121112.46},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31794.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":77889.53},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":94219.14},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31488.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":72223.29},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":107178.19},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":133548.3},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32711.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31335.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":62374.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32405.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":67868.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32680.75,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Adrenal And Pituitary Procedures With Cc/Mcc","code_information":[{"code":"614","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19568.8,"maximum":82240.72,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":74582.57},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19855.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":47965.35},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":58021.33},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19664.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":44476.01},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":66001.67},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":82240.72},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20427.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19568.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":38952.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20237.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":42383.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20408.82,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Non-Malignant Breast Disorders With Cc/Mcc","code_information":[{"code":"600","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9671.04,"maximum":39082.92,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35443.56},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9812.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22794.37},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":27573.24},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9718.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":21136.15},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31365.7},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":39082.92},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10095.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9671.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19250.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10001.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":20946.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10086.19,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Ulcers With Mcc","code_information":[{"code":"592","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17361.55,"maximum":72616.33,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":65854.39},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17615.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42352.11},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":51231.26},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17446.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":39271.11},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":58277.69},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":72616.33},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18123.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17361.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34558.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17954.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":37602.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18106.83,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Graft Except For Skin Ulcer Or Cellulitis Without Cc/Mcc","code_information":[{"code":"578","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14531.28,"maximum":60275.34,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":54662.58},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14743.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35154.46},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":42524.62},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14602.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":32597.07},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":48373.52},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":60275.34},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15169.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14531.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28925.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15027.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":31472.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15155.06,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Debridement With Mcc","code_information":[{"code":"570","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":26016.7,"maximum":110355.95,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":100079.75},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26397.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":64363.03},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":77856.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26143.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":59680.8},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":88565.34},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":110355.95},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27158.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26016.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":51787.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26905.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":56348.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27133.52,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Aftercare, Musculoskeletal System And Connective Tissue With Mcc","code_information":[{"code":"559","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16755.74,"maximum":69974.78,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":63458.82},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17000.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40811.47},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":49367.63},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16837.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":37842.55},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":56157.73},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":69974.78},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17491.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16755.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":33352.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17327.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":36290.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17475.01,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":69974.78,"10th_percentile":69974.78,"90th_percentile":69974.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Medical Back Problems With Mcc","code_information":[{"code":"551","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15131.07,"maximum":62890.62,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57034.33},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15352.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36679.77},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":44369.72},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15204.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":34011.42},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":50472.4},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":62890.62},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15795.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15131.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30118.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15647.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":32771.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15780.6,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":13872.01,"10th_percentile":13872.01,"90th_percentile":13872.01},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With Cc","code_information":[{"code":"543","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9554.0,"maximum":38572.62,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34980.78},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9693.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22496.75},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":27213.22},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9600.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":20860.18},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30956.16},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":38572.62},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9973.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9554.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19017.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9880.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":20692.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9964.13,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Fractures Of Hip And Pelvis With Mcc","code_information":[{"code":"535","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11739.75,"maximum":48103.2,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43623.9},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11911.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28055.29},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":33937.1},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11797.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":26014.34},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":38604.87},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":48103.2},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12255.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11739.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23368.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12140.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":25426.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12243.7,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cirrhosis And Alcoholic Hepatitis Without Cc/Mcc","code_information":[{"code":"434","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6839.06,"maximum":26734.43,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24244.95},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6939.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15592.35},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":18861.3},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6872.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":14458.05},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21455.51},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":26734.43},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7139.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6839.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13613.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7072.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14812.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7132.64,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Hepatobiliary Or Pancreas O.R. Procedures Without Cc/Mcc","code_information":[{"code":"425","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13618.26,"maximum":56294.26,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51052.21},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13817.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32832.57},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":39715.94},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13684.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":30444.09},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45178.53},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":56294.26},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14216.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13618.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27107.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14083.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29495.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14202.85,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Laparoscopic Cholecystectomy Without C.D.E. With Mcc","code_information":[{"code":"417","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21243.38,"maximum":89542.5,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":81204.42},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21554.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":52223.98},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":63172.78},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21347.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":48424.83},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":71861.66},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":89542.5},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22176.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21243.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":42285.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21968.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":46010.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22155.29,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":19472.67,"10th_percentile":19472.67,"90th_percentile":19472.67},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Complicated Peptic Ulcer With Mcc","code_information":[{"code":"380","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17593.03,"maximum":73625.67,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":66769.74},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17850.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42940.78},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":51943.36},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17678.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":39816.96},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":59087.73},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":73625.67},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18365.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17593.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":35019.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18193.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":38103.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18348.24,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Vaginal Delivery With Sterilization And/Or D&C With Cc","code_information":[{"code":"797","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9316.5,"maximum":37537.01,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34041.61},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9452.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21892.75},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":26482.59},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9361.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":20300.12},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30125.05},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":37537.01},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9725.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9316.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18544.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9634.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":20178.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9716.43,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Procedures With Cc/Mcc","code_information":[{"code":"829","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":27900.4,"maximum":118569.52,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":107528.48},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28308.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":69153.44},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":83651.52},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28036.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":64122.72},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":95157.08},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":118569.52},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29125.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27900.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":55536.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28853.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":60428.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29098.07,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses Without Cc/Mcc","code_information":[{"code":"845","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8036.04,"maximum":31953.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28978.24},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8153.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18636.41},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":22543.56},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8075.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":17280.67},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25644.23},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":31953.74},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8388.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8036.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15996.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8310.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17404.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8381.0,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Alcohol, Drug Abuse Or Dependence, Left Ama","code_information":[{"code":"894","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6016.39,"maximum":23147.32,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20991.87},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6104.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13500.24},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":16330.58},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6045.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":12518.13},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18576.71},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":23147.32},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6280.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6016.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11975.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6221.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":13030.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6274.66,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":10507.6,"10th_percentile":10507.6,"90th_percentile":10507.6},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Grafts For Injuries Without Cc/Mcc","code_information":[{"code":"905","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13472.84,"maximum":55660.13,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50477.14},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13670.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32462.73},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":39268.56},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13538.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":30101.15},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":44669.62},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":55660.13},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14064.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13472.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26818.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13932.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29180.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14051.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Allergic Reactions Without Mcc","code_information":[{"code":"916","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6441.49,"maximum":25000.91,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22672.86},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6535.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14581.31},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":17638.29},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6472.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":13520.56},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20064.29},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":25000.91},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6724.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6441.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12822.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6661.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":13951.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6718.0,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Menstrual And Other Female Reproductive System Disorders With Cc/Mcc","code_information":[{"code":"760","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9377.6,"maximum":37803.42,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34283.21},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9514.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22048.13},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":26670.54},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9423.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":20444.19},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30338.85},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":37803.42},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9789.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9377.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18666.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9697.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":20310.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9780.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8538.82,"10th_percentile":8538.82,"90th_percentile":8538.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21192.21,"10th_percentile":21192.21,"90th_percentile":21192.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cesarean Section With Sterilization With Cc","code_information":[{"code":"784","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9830.24,"maximum":39777.07,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36073.08},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9974.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23199.23},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":28062.97},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9878.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":21511.55},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31922.79},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":39777.07},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10261.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9830.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19567.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10165.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":21290.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10252.22,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"1 through 10","median_amount":15064.02,"10th_percentile":15064.02,"90th_percentile":15064.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Prematurity Without Major Problems","code_information":[{"code":"792","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21783.78,"maximum":91898.88,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":83341.38},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22102.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":53598.29},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":64835.22},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21890.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":49699.17},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":73752.76},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":91898.88},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22740.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21783.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":43361.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22527.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":47180.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22718.89,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":970.95,"10th_percentile":970.95,"90th_percentile":970.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Splenic Procedures With Cc","code_information":[{"code":"800","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":24883.39,"maximum":105414.31,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":95598.26},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25247.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":61480.91},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":74370.44},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25004.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":57008.34},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":84599.46},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":105414.31},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25975.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24883.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":49531.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25733.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":53893.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25951.56,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Coagulation Disorders ","code_information":[{"code":"808","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19707.34,"maximum":82844.82,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":75130.42},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19995.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":48317.68},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":58447.53},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19803.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":44802.71},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":66486.49},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":82844.82},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20572.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19707.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":39228.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20380.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":42683.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20553.31,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19358.66,"10th_percentile":19358.66,"90th_percentile":19358.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Reticuloendothelial And Immunity Disorders Without Cc/Mcc","code_information":[{"code":"816","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6146.33,"maximum":23713.9,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21505.7},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6236.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13830.69},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":16730.3},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6176.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":12824.54},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19031.42},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":23713.9},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6416.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6146.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12234.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6356.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":13312.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6410.17,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lymphoma And Non-Acute Leukemia With Other Procedures With Cc","code_information":[{"code":"824","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":20203.87,"maximum":85009.84,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":77093.84},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20499.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":49580.39},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":59974.96},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20302.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":45973.56},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":68224.01},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":85009.84},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21090.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20203.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":40216.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20893.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":43758.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21071.16,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Antepartum Diagnoses Without O.R. Procedures With Cc","code_information":[{"code":"832","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6917.36,"maximum":27075.88,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24554.6},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7018.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15791.49},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":19102.2},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6951.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":14642.71},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21729.54},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":27075.88},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7221.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6917.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13769.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7153.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14981.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7214.3,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":12775.22,"10th_percentile":12775.22,"90th_percentile":12775.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10412.5,"10th_percentile":10412.5,"90th_percentile":10412.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":1774.74,"10th_percentile":1774.74,"90th_percentile":2573.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2456.51,"10th_percentile":2456.51,"90th_percentile":2456.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lymphoma And Non-Acute Leukemia With Mcc","code_information":[{"code":"840","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":28544.93,"maximum":121379.92,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":110077.18},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28962.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":70792.55},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":85634.27},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28684.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":65642.59},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":97412.54},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":121379.92},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29798.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28544.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":56819.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29519.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":61824.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29770.27,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pulmonary Embolism With Mcc Or Acute Cor Pulmonale","code_information":[{"code":"175","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12527.98,"maximum":51540.22,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46740.86},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12711.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30059.86},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":36361.94},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12589.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":27873.09},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":41363.22},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":51540.22},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13077.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12527.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24937.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12955.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":27133.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13065.77,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Dental And Oral Diseases Without Cc/Mcc","code_information":[{"code":"159","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6804.64,"maximum":26584.34,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24108.84},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6904.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15504.81},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":18755.41},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6837.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":14376.88},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21335.06},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":26584.34},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7103.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6804.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13544.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7036.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14737.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7096.74,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Epistaxis Without Mcc","code_information":[{"code":"151","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7024.07,"maximum":27541.15,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24976.55},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7126.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16062.86},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":19430.45},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7058.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":14894.33},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22102.94},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":27541.15},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7332.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7024.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13981.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7263.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":15213.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7325.59,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Ear, Nose, Mouth And Throat O.R. Procedures With Mcc","code_information":[{"code":"143","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":32948.24,"maximum":140579.93,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":127489.3},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33430.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":81990.59},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":99180.0},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33108.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":76026.01},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":112821.37},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":140579.93},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34394.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32948.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":65584.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34073.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":71361.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34362.6,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Sinus And Mastoid Procedures With Cc/Mcc","code_information":[{"code":"135","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19381.2,"maximum":81422.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":73840.76},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19664.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":47488.28},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":57444.24},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19475.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":44033.64},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":65345.21},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":81422.74},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20232.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19381.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":38578.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20043.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":41976.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20213.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extraocular Procedures Except Orbit","code_information":[{"code":"115","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13916.0,"maximum":57592.52,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52229.58},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14119.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33589.75},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":40631.87},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13983.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":31146.19},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46220.44},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":57592.52},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14526.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13916.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27700.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14391.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":30140.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14513.37,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Non-Bacterial Infection Of Nervous System Except Viral Meningitis With Cc","code_information":[{"code":"098","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":20456.0,"maximum":86109.24,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":78090.86},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20755.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":50221.59},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":60750.59},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20555.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":46568.11},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":69106.32},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":86109.24},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21354.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20456.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":40718.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21154.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":44304.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21334.11,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Concussion Without Cc/Mcc","code_information":[{"code":"090","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7791.65,"maximum":30888.11,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28011.85},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7905.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18014.91},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":21791.75},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7829.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":16704.37},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24789.02},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":30888.11},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8133.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7791.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15509.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8057.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16875.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8126.12,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Traumatic Stupor And Coma >1 Hour With Mcc","code_information":[{"code":"082","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":20375.96,"maximum":85760.28,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":77774.4},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20674.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":50018.07},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":60504.4},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20475.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":46379.4},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":68826.27},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":85760.28},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21270.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20375.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":40559.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21071.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":44131.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21250.64,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Cerebrovascular Disorders With Cc","code_information":[{"code":"071","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9536.79,"maximum":38497.57,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34912.73},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9676.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22452.98},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":27160.27},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9583.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":20819.59},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30895.94},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":38497.57},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9955.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9536.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18983.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9862.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":20655.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9946.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8676.38,"10th_percentile":8676.38,"90th_percentile":8676.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8843.24,"10th_percentile":8843.24,"90th_percentile":8843.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic Agent Without Cc/Mcc","code_information":[{"code":"063","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12787.86,"maximum":52673.38,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47768.51},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12975.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30720.76},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":37161.39},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12850.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":28485.91},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42272.63},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":52673.38},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13349.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12787.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25454.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13224.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":27696.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13336.8,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Nervous System Neoplasms Without Mcc","code_information":[{"code":"055","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9481.72,"maximum":38257.43,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34694.95},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9620.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22312.93},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":26990.85},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9527.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":20689.72},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30703.21},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":38257.43},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9897.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9481.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18873.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9805.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":20536.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9888.74,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extracranial Procedures With Cc","code_information":[{"code":"038","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14670.69,"maximum":60883.2,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55213.83},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14885.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35508.98},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":42953.47},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14742.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":32925.8},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":48861.35},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":60883.2},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15314.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14670.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29202.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15171.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":31774.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15300.46,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Spinal Procedures Without Cc/Mcc","code_information":[{"code":"030","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19598.05,"maximum":82368.29,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":74698.27},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19884.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":48039.76},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":58111.33},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19693.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":44545.0},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":66104.06},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":82368.29},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20458.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19598.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":39010.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20267.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":42446.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20439.33,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/Mcc","code_information":[{"code":"022","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":28050.13,"maximum":119222.4,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":108120.57},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28460.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":69534.22},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":84112.13},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28186.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":64475.8},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":95681.05},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":119222.4},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29281.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28050.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":55834.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29007.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":60752.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29254.23,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc","code_information":[{"code":"013","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":25506.42,"maximum":108130.9,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":98061.89},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25879.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":63065.31},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":76287.01},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25630.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":58477.49},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":86779.64},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":108130.9},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26626.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25506.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":50771.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26377.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":55243.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26601.33,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Neck Without Major O.R.","code_information":[{"code":"004","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":119902.54,"maximum":519732.23,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":471335.44},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":121657.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":303124.04},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":366674.26},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":120487.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":281072.61},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":417107.21},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":519732.23},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":125166.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":119902.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":238670.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":123996.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":259691.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":125049.58,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pulmonary Embolism Without Mcc","code_information":[{"code":"176","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7635.04,"maximum":30205.21,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27392.54},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7746.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17616.62},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":21309.96},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7672.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":16335.06},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24240.97},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":30205.21},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7970.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7635.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15197.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7895.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16536.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7962.79,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Chest Procedures With Mcc","code_information":[{"code":"163","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":39274.81,"maximum":168166.1,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":152506.69},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39849.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":98079.71},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":118642.21},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39466.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":90944.69},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":134960.44},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":168166.1},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40999.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39274.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":78177.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40615.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":85063.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40960.76,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Otitis Media And Uri With Mcc","code_information":[{"code":"152","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10880.94,"maximum":44358.51,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40227.9},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11040.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25871.26},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":31295.2},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10934.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":23989.2},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35599.59},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":44358.51},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11358.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10880.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21658.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11252.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":23566.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11348.02,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Ear, Nose, Mouth And Throat O.R. Procedures With Cc","code_information":[{"code":"144","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15619.85,"maximum":65021.87,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":58967.12},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15848.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":37922.78},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":45873.33},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15696.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":35164.01},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":52182.82},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":65021.87},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16305.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15619.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31091.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16153.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":33830.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16290.36,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Sinus And Mastoid Procedures Without Cc/Mcc","code_information":[{"code":"136","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9444.72,"maximum":38096.09,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34548.63},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9582.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22218.83},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":26877.02},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9490.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":20602.47},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30573.73},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":38096.09},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9859.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9444.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18800.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9767.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":20455.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9850.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Intraocular Procedures With Cc/Mcc","code_information":[{"code":"116","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16266.97,"maximum":67843.53,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61526.03},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16505.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39568.46},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":47864.02},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16346.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":36689.97},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":54447.32},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":67843.53},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16981.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16266.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32379.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16822.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":35231.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16965.25,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Non-Bacterial Infection Of Nervous System Except Viral Meningitis Without Cc/Mcc","code_information":[{"code":"099","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12431.6,"maximum":51119.97,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46359.75},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12613.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29814.76},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":36065.45},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12492.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":27645.82},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":41025.95},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":51119.97},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12977.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12431.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24745.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12856.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":26925.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12965.25,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Disorders Of Nervous System With Mcc","code_information":[{"code":"091","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15820.35,"maximum":65896.14,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59759.97},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16051.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":38432.68},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":46490.13},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15897.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":35636.81},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":52884.45},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":65896.14},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16514.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15820.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31490.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16360.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":34264.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16499.47,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Traumatic Stupor And Coma >1 Hour With Cc","code_information":[{"code":"083","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12719.02,"maximum":52373.21,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47496.28},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12905.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30545.69},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":36949.62},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12781.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":28323.57},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42031.73},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":52373.21},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13277.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12719.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25317.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13153.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":27547.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13265.01,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Cerebrovascular Disorders Without Cc/Mcc","code_information":[{"code":"072","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7215.1,"maximum":28374.14,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25731.97},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7320.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16548.68},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":20018.13},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7250.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":15344.81},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22771.45},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":28374.14},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7531.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7215.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14361.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7461.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":15626.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7524.82,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Intracranial Hemorrhage Or Cerebral Infarction With Mcc","code_information":[{"code":"064","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18012.97,"maximum":75456.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":68430.31},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18276.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":44008.72},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":53235.19},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18100.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":40807.21},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":60557.24},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":75456.74},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18803.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18012.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":35855.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18628.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":39013.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18786.21,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":75456.74,"10th_percentile":75456.74,"90th_percentile":75456.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1770.0,"10th_percentile":1770.0,"90th_percentile":1770.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":14836.08,"10th_percentile":14836.08,"90th_percentile":14856.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Degenerative Nervous System Disorders With Mcc","code_information":[{"code":"056","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":20698.67,"maximum":87167.36,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":79050.45},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21001.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":50838.72},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":61497.1},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20799.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":47140.35},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":69955.51},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":87167.36},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21607.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20698.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":41201.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21405.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":44830.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21587.19,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19062.83,"10th_percentile":19062.83,"90th_percentile":19062.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":17269.88,"10th_percentile":17269.88,"90th_percentile":17269.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extracranial Procedures Without Cc/Mcc","code_information":[{"code":"039","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10823.28,"maximum":44107.11,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39999.91},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10981.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25724.64},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":31117.84},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10876.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":23853.25},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35397.83},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":44107.11},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11298.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10823.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21544.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11192.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":23441.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11287.89,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ventricular Shunt Procedures With Mcc","code_information":[{"code":"031","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":39263.63,"maximum":168117.32,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":152462.45},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39838.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":98051.26},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":118607.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39455.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":90918.31},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":134921.3},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":168117.32},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40987.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39263.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":78155.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40604.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":85039.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40949.09,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis With Mcc Or Antineopla","code_information":[{"code":"023","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":50018.46,"maximum":215012.32,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":194990.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50750.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":125401.89},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":151692.5},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50262.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":116279.25},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":172556.52},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":215012.32},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52214.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50018.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":99563.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51726.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":108332.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52165.6,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Allogeneic Bone Marrow Transplant","code_information":[{"code":"014","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":104124.82,"maximum":450935.64,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":408945.1},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":105648.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":262999.72},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":318137.85},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":104632.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":243867.23},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":361895.02},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":450935.64},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":108696.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":104124.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":207264.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":107680.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":225519.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":108594.57,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Liver Transplant With Mcc Or Intestinal Transplant","code_information":[{"code":"005","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":89432.22,"maximum":386870.58,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":350845.69},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":90740.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":225634.98},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":272939.56},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":89868.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":209220.67},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":310480.09},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":386870.58},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":93358.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":89432.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":178018.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":92486.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":193697.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":93271.27,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/Mcc","code_information":[{"code":"042","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15575.1,"maximum":64826.76,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":58790.18},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15803.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":37808.99},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":45735.67},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15651.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":35058.49},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":52026.23},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":64826.76},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16258.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15575.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31002.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16106.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":33733.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16243.69,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Carotid Artery Stent Procedures With Mcc","code_information":[{"code":"034","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":34016.14,"maximum":145236.41,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":131712.18},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34513.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":84706.4},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":102465.17},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34182.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":78544.24},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":116558.39},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":145236.41},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35509.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34016.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":67710.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35177.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":73673.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35476.35,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Craniotomy And Endovascular Intracranial Procedures With Cc","code_information":[{"code":"026","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":27463.25,"maximum":116663.4,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":105799.86},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27865.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":68041.73},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":82306.74},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27597.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":63091.89},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":93627.34},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":116663.4},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28668.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27463.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":54666.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28401.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":59481.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28642.16,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Simultaneous Pancreas, Islet Cell And Kidney Transplant","code_information":[{"code":"008","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":48936.79,"maximum":210295.8,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":190713.33},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49652.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":122651.07},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":148364.97},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49175.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":113728.54},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":168771.32},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":210295.8},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51085.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48936.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":97410.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50607.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":105989.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51037.49,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Vascular Procedures Without Cc/Mcc","code_information":[{"code":"254","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16039.78,"maximum":66852.95,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":60627.69},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16274.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":38990.72},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":47165.16},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16118.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":36154.26},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":53652.33},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":66852.95},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16743.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16039.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31927.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16587.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":34739.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16728.32,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Permanent Cardiac Pacemaker Implant With Mcc","code_information":[{"code":"242","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":28182.65,"maximum":119800.24,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":108644.6},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28595.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":69871.24},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":84519.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28320.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":64788.3},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":96144.79},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":119800.24},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29419.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28182.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":56098.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29144.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":61039.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29392.44,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":286.0,"10th_percentile":286.0,"90th_percentile":286.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical With Mcc","code_information":[{"code":"426","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":95547.97,"maximum":413537.47,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":375029.39},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":96946.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":241187.94},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":291753.21},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":96014.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":223642.19},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":331881.4},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":413537.47},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":99742.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":95547.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":190191.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":98810.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":206942.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":99649.54,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Coronary Bypass With Ptca Without Mcc","code_information":[{"code":"232","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":52877.99,"maximum":227480.88,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":206298.15},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53651.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":132673.94},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":160489.15},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53135.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":123022.28},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":182563.07},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":227480.88},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":55199.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52877.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":105255.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54683.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":114525.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":55147.87,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With Cc","code_information":[{"code":"217","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":57289.89,"maximum":246718.41,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":223744.31},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":58128.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":143893.87},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":174061.34},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57569.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":133425.99},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":198002.01},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":246718.41},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":59805.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57289.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":114037.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":59246.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":124081.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":59749.17,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Respiratory System Diagnoses Without Mcc","code_information":[{"code":"206","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8806.22,"maximum":35311.95,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32023.75},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8935.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20595.03},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":24912.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8849.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":19096.8},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28339.34},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":35311.95},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9192.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8806.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17529.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9106.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":19072.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9184.24,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Interstitial Lung Disease Without Cc/Mcc","code_information":[{"code":"198","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6870.89,"maximum":26873.26,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24370.85},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6971.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15673.32},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":18959.25},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6904.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":14533.13},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21566.93},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":26873.26},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7172.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6870.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13676.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7105.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14881.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7165.84,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Chronic Obstructive Pulmonary Disease With Mcc","code_information":[{"code":"190","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10239.84,"maximum":41563.12,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37692.82},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10389.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24240.91},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":29323.03},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10289.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":22477.45},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33356.17},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":41563.12},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10689.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10239.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20382.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10589.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":22178.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10679.41,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8894.21,"10th_percentile":8894.21,"90th_percentile":8894.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":9412.76,"10th_percentile":9412.76,"90th_percentile":9412.76},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":9400.76,"10th_percentile":9400.76,"90th_percentile":9400.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Respiratory Neoplasms Without Cc/Mcc","code_information":[{"code":"182","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7194.45,"maximum":28284.08,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25650.31},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7299.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16496.16},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":19954.59},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7229.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":15296.11},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22699.18},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":28284.08},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7510.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7194.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14320.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7440.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":15582.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7503.29,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary Embolism","code_information":[{"code":"173","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":26320.47,"maximum":111680.48,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":101280.94},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26705.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":65135.54},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":78791.26},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26448.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":60397.11},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":89628.33},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":111680.48},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27476.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26320.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":52391.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27219.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":57006.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27450.33,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Dental And Oral Diseases With Cc","code_information":[{"code":"158","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8536.87,"maximum":34137.52,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30958.67},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8661.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19910.06},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":24084.23},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8578.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":18461.66},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27396.81},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":34137.52},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8911.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8536.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16992.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8828.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":18489.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8903.33,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Epistaxis With Mcc","code_information":[{"code":"150","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12165.7,"maximum":49960.54,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45308.28},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12343.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29138.55},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":35247.47},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12225.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":27018.8},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40095.46},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":49960.54},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12699.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12165.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24216.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12581.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":26349.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12687.94,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Head And Neck Procedures Without Cc/Mcc","code_information":[{"code":"142","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14445.23,"maximum":59900.12,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":54322.3},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14656.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34935.62},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":42259.9},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14515.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":32394.15},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":48072.39},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":59900.12},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15079.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14445.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28753.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14938.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":31286.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15065.32,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Disorders Of The Eye Without Mcc","code_information":[{"code":"125","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7314.92,"maximum":28809.39,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26126.7},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7421.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16802.54},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":20325.2},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7350.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":15580.2},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23120.76},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":28809.39},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7636.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7314.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14560.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7564.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":15843.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7628.93,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Orbital Procedures Without Cc/Mcc","code_information":[{"code":"114","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12350.72,"maximum":50767.27,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46039.88},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12531.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29609.05},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":35816.62},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12410.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":27455.08},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40742.89},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":50767.27},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12892.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12350.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24584.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12772.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":26749.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12880.89,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Non-Bacterial Infection Of Nervous System Except Viral Meningitis With Mcc","code_information":[{"code":"097","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":31788.24,"maximum":135521.96,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":122902.33},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32253.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":79040.63},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":95611.57},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31943.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":73290.65},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":108762.13},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":135521.96},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33183.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31788.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":63275.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32873.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":68848.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33152.81,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Concussion With Cc","code_information":[{"code":"089","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10161.54,"maximum":41221.67,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37383.16},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10310.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24041.76},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":29082.14},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10211.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":22292.79},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33082.14},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":41221.67},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10607.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10161.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20226.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10508.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":22008.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10597.75,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Nontraumatic Stupor And Coma Without Mcc","code_information":[{"code":"081","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8414.68,"maximum":33604.7,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30475.48},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8537.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19599.31},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":23708.32},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8455.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":18173.52},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26969.2},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":33604.7},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8784.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8414.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16749.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8702.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":18224.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8775.89,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Cerebrovascular Disorders With Mcc","code_information":[{"code":"070","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15033.83,"maximum":62466.63,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56649.81},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15253.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36432.48},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":44070.59},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15107.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":33782.12},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":50132.12},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":62466.63},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15693.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15033.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29925.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15547.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":32561.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15679.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic Agent With Cc","code_information":[{"code":"062","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15828.95,"maximum":65933.66,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59794.0},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16060.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":38454.56},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":46516.6},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15906.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":35657.1},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":52914.56},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":65933.66},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16523.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15828.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31508.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16369.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":34283.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16508.44,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":35561.11,"10th_percentile":35561.11,"90th_percentile":35561.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Nervous System Neoplasms With Mcc","code_information":[{"code":"054","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13847.17,"maximum":57292.34,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51957.35},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14049.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33414.68},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":40420.1},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13914.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":30983.85},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45979.54},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":57292.34},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14455.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13847.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27563.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14320.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29990.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14441.58,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12067.45,"10th_percentile":12067.45,"90th_percentile":12067.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":30725.47,"10th_percentile":30725.47,"90th_percentile":30725.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extracranial Procedures With Mcc","code_information":[{"code":"037","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":29037.15,"maximum":123526.18,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":112023.58},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29462.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":72044.32},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":87148.47},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29178.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":66803.29},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":99135.01},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":123526.18},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30311.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29037.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":57799.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30028.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":62890.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30283.63,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Spinal Procedures With Cc Or Spinal Neurostimulators","code_information":[{"code":"029","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":30065.47,"maximum":128010.06,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":116089.92},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30505.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":74659.45},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":90311.88},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30212.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":69228.19},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":102733.51},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":128010.06},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31385.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30065.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":59846.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31092.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":65117.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31356.09,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Neck With Major","code_information":[{"code":"003","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":183355.92,"maximum":796411.95,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":722251.11},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":186039.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":464492.28},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":561873.49},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":184250.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":430701.76},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":639154.45},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":796411.95},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":191405.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":183355.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":364976.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":189616.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":397122.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":191226.8,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extensive O.R. Procedures Unrelated To Principal Diagnosis Without Cc/Mcc","code_information":[{"code":"983","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15457.2,"maximum":64312.71,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":58323.99},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15683.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":37509.18},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":45373.01},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15532.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":34780.49},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":51613.68},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":64312.71},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16135.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15457.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30768.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15985.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":33478.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16120.73,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hiv With Extensive O.R. Procedures With Mcc","code_information":[{"code":"969","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":53383.12,"maximum":229683.42,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":208295.6},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54164.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":133958.53},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":162043.05},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53643.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":124213.42},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":184330.71},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":229683.42},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":55726.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53383.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":106261.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":55205.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":115620.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":55674.69,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"O.R. Procedures With Diagnoses Of Other Contact With Health Services Without Cc/Mcc","code_information":[{"code":"941","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18156.68,"maximum":76083.36,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":68998.58},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18422.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":44374.19},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":53677.27},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18245.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":41146.09},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":61060.13},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":76083.36},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18953.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18156.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":36141.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18776.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":39324.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18936.08,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft","code_information":[{"code":"927","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":184434.15,"maximum":801113.46,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":726514.81},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":187133.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":467234.34},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":565190.44},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":185333.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":433244.35},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":642927.61},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":801113.46},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":192531.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":184434.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":367122.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":190731.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":399457.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":192351.33,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Adjustment Reaction And Psychosocial Dysfunction","code_information":[{"code":"880","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8970.57,"maximum":36028.62,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32673.69},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9101.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21013.02},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":25418.41},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9014.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":19484.38},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28914.5},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":36028.62},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9364.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8970.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17856.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9276.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":19428.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9355.65,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Viral Illness Without Mcc","code_information":[{"code":"866","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8190.94,"maximum":32629.13,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29590.75},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8310.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19030.33},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":23020.05},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8230.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":17645.92},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26186.26},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":32629.13},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8550.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8190.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16304.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8470.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17740.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8542.55,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Chemotherapy Without Acute Leukemia As Secondary Diagnosis Without Cc/Mcc","code_information":[{"code":"848","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8017.11,"maximum":31871.19,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28903.38},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8134.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18588.27},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":22485.32},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8056.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":17236.02},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25577.98},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":31871.19},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8369.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8017.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15958.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8290.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17363.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8361.26,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Postoperative Or Post-Traumatic Infections With O.R. Procedures Without Cc/Mcc","code_information":[{"code":"858","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12694.06,"maximum":52264.39,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47397.6},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12879.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30482.22},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":36872.85},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12755.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":28264.73},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":41944.4},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":52264.39},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13251.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12694.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25267.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13127.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":27493.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13238.98,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Infectious And Parasitic Diseases Diagnoses Without Cc/Mcc","code_information":[{"code":"869","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6987.07,"maximum":27379.8,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24830.23},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7089.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15968.75},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":19316.62},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7021.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":14807.07},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21973.46},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":27379.8},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7293.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6987.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13908.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7225.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":15132.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7287.0,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Disorders Of Personality And Impulse Control","code_information":[{"code":"883","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17628.31,"maximum":73779.51,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":66909.26},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17886.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":43030.51},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":52051.89},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17714.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":39900.16},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":59211.19},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":73779.51},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18402.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17628.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":35089.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18230.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":38180.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18385.04,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc","code_information":[{"code":"897","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8304.53,"maximum":33124.42,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30039.92},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8426.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19319.2},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":23369.48},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8345.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":17913.78},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26583.76},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":33124.42},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8669.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8304.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16530.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8588.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17986.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8661.02,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Procedures For Injuries With Cc","code_information":[{"code":"908","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17877.0,"maximum":74863.89,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":67892.67},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18138.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":43662.96},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":52816.93},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17964.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":40486.6},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":60081.46},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":74863.89},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18661.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17877.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":35584.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18487.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":38718.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18644.41,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Complications Of Treatment With Mcc","code_information":[{"code":"919","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16462.3,"maximum":68695.28,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62298.46},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16703.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40065.23},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":48464.94},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16542.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":37150.59},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":55130.88},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":68695.28},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17185.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16462.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32768.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17024.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":35654.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17168.97,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":172.93,"10th_percentile":172.93,"90th_percentile":172.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft","code_information":[{"code":"933","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":34218.37,"maximum":146118.17,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":132511.84},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34719.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":85220.67},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":103087.26},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34385.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":79021.11},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":117266.04},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":146118.17},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35720.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34218.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":68112.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35386.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":74111.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35687.26,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Signs And Symptoms With Mcc","code_information":[{"code":"947","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11631.31,"maximum":47630.43,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43195.14},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11801.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27779.55},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":33603.56},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11688.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":25758.66},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":38225.44},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":47630.43},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12141.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11631.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23152.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12028.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":25191.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12130.61,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other O.R. Procedures For Multiple Significant Trauma With Cc","code_information":[{"code":"958","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":36969.46,"maximum":158113.96,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":143390.59},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37510.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":92216.99},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":111550.36},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37149.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":85508.46},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":126893.17},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":158113.96},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38592.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36969.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":73589.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38231.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":80070.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38556.45,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hiv With Major Related Condition With Cc","code_information":[{"code":"975","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11851.61,"maximum":48590.99,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44066.26},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12025.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28339.78},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":34281.24},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11909.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":26278.14},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":38996.34},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":48590.99},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12371.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11851.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23591.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12256.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":25668.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12360.37,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":8473.93,"10th_percentile":8473.93,"90th_percentile":8473.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Non-Extensive O.R. Procedures Unrelated To Principal Diagnosis Without Cc/Mcc","code_information":[{"code":"989","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11027.23,"maximum":44996.38,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40806.38},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11188.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26243.29},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":31745.22},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11081.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":24334.17},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36111.51},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":44996.38},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11511.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11027.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21950.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11403.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":23883.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11500.59,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Liver Transplant Without Mcc","code_information":[{"code":"006","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":40610.35,"maximum":173989.51,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":157787.84},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41204.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":101476.11},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":122750.66},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40808.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":94094.0},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":139633.98},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":173989.51},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42393.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40610.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":80836.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41997.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":87956.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42353.62,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Autologous Bone Marrow Transplant With Cc/Mcc","code_information":[{"code":"016","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":51734.35,"maximum":222494.2,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":201775.83},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52491.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":129765.55},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":156971.02},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51986.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":120325.47},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":178561.06},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":222494.2},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54005.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51734.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":102979.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53500.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":112049.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53955.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Without Mcc","code_information":[{"code":"024","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":34370.68,"maximum":146782.31,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":133114.13},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34873.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":85608.02},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":103555.82},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34538.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":79380.27},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":117799.04},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":146782.31},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35879.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34370.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":68416.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35544.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":74441.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35846.1,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ventricular Shunt Procedures With Cc","code_information":[{"code":"032","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19045.6,"maximum":79959.38,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":72513.67},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19324.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46634.8},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":56411.83},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19138.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":43242.25},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":64170.8},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":79959.38},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19881.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19045.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37910.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19695.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":41249.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19863.16,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc","code_information":[{"code":"040","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":33934.4,"maximum":144879.95,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":131388.91},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34431.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":84498.5},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":102213.69},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34099.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":78351.47},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":116272.32},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":144879.95},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35424.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33934.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":67547.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35093.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":73496.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35391.09,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Degenerative Nervous System Disorders Without Mcc","code_information":[{"code":"057","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11856.77,"maximum":48613.5,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44086.68},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12030.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28352.91},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":34297.12},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11914.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":26290.32},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39014.4},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":48613.5},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12377.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11856.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23601.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12261.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":25680.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12365.74,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10674.0,"10th_percentile":10674.0,"90th_percentile":10674.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours","code_information":[{"code":"065","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9401.7,"maximum":37908.48,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34378.49},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9539.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22109.41},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":26744.66},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9447.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":20501.01},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30423.16},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":37908.48},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9814.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9401.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18714.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9722.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":20362.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9805.28,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9051.16,"10th_percentile":9051.16,"90th_percentile":9051.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":50106.4,"10th_percentile":50106.4,"90th_percentile":50106.4},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":6970.63,"10th_percentile":6970.63,"90th_percentile":6985.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cranial And Peripheral Nerve Disorders With Mcc","code_information":[{"code":"073","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14513.21,"maximum":60196.54,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":54591.12},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14725.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35108.5},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":42469.03},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14584.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":32554.46},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":48310.29},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":60196.54},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15150.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14513.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28889.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15008.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":31433.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15136.22,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Traumatic Stupor And Coma >1 Hour Without Cc/Mcc","code_information":[{"code":"084","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8932.71,"maximum":35863.53,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32523.96},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9063.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20916.73},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":25301.94},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8976.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":19395.09},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28782.01},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":35863.53},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9324.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8932.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17780.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9237.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":19346.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9316.16,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Disorders Of Nervous System With Cc","code_information":[{"code":"092","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9510.99,"maximum":38385.01,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34810.64},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9650.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22387.33},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":27080.86},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9557.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":20758.72},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30805.6},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":38385.01},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9928.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9510.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18931.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9835.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":20599.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9919.26,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Seizures With Mcc","code_information":[{"code":"100","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17374.46,"maximum":72672.61,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":65905.43},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17628.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42384.93},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":51270.97},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17459.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":39301.55},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":58322.86},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":72672.61},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18137.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17374.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34584.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17967.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":37630.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18120.29,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15766.38,"10th_percentile":15766.38,"90th_percentile":15766.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":4954.19,"10th_percentile":4954.19,"90th_percentile":4954.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":14567.55,"10th_percentile":14567.55,"90th_percentile":14567.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Female Reproductive System O.R. Procedures With Cc/Mcc","code_information":[{"code":"749","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":22802.65,"maximum":96341.49,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":87370.29},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23136.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":56189.36},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":67969.51},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22913.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":52101.74},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":77318.14},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":96341.49},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23803.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22802.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":45389.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23581.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":49387.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23781.5,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy Without Cc/Mcc","code_information":[{"code":"741","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12979.76,"maximum":53510.12,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48527.33},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13169.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31208.77},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":37751.72},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13043.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":28938.42},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42944.15},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":53510.12},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13549.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12979.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25836.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13422.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":28112.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13536.94,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Male Reproductive System Diagnoses Without Cc/Mcc","code_information":[{"code":"730","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6490.54,"maximum":25214.78,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22866.82},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6585.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14706.05},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":17789.18},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6522.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":13636.22},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20235.94},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":25214.78},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6775.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6490.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12919.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6712.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14057.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6769.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignancy, Male Reproductive System With Mcc","code_information":[{"code":"722","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16280.73,"maximum":67903.56,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61580.47},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16518.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39603.47},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":47906.38},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16360.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":36722.43},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":54495.5},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":67903.56},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16995.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16280.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32407.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16836.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":35261.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16979.61,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Testes Procedures With Cc/Mcc","code_information":[{"code":"711","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18639.43,"maximum":78188.34,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":70907.55},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18912.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45601.88},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":55162.35},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18730.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":42284.47},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":62749.47},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":78188.34},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19457.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18639.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37102.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19275.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":40370.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19439.56,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Urethral Stricture","code_information":[{"code":"697","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9982.55,"maximum":40441.21,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36675.38},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10128.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23586.58},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":28531.52},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10031.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":21870.72},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32455.79},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":40441.21},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10420.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9982.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19870.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10323.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":21620.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10411.07,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Urinary Tract Neoplasms With Cc","code_information":[{"code":"687","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9724.39,"maximum":39315.55,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35654.54},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9866.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22930.06},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":27737.36},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9771.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":21261.96},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31552.4},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":39315.55},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10151.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9724.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19356.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10056.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":21061.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10141.83,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Urethral Procedures Without Cc/Mcc","code_information":[{"code":"672","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9997.18,"maximum":40505.0,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36733.23},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10143.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23623.78},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":28576.52},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10045.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":21905.21},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32506.98},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":40505.0},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10436.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9997.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19899.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10338.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":21652.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10426.33,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Minor Bladder Procedures Without Cc/Mcc","code_information":[{"code":"664","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9716.65,"maximum":39281.78,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35623.91},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9858.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22910.36},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":27713.54},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9764.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":21243.69},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31525.3},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":39281.78},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10143.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9716.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19341.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10048.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":21044.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10133.76,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Ureter Procedures For Neoplasm With Mcc","code_information":[{"code":"656","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":28105.2,"maximum":119462.54,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":108338.35},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28516.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":69674.28},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":84281.55},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28242.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":64605.67},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":95873.77},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":119462.54},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29339.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28105.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":55944.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29064.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":60871.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29311.67,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Musculoskeletal System And Connective Tissue O.R. Procedures Without Cc/Mcc","code_information":[{"code":"517","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13931.5,"maximum":57660.06,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52290.83},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14135.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33629.14},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":40679.52},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13999.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":31182.72},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46274.65},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":57660.06},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14543.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13931.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27731.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14407.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":30173.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14529.54,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Shoulder Or Elbow Joint Procedures Without Cc/Mcc","code_information":[{"code":"508","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13739.6,"maximum":56823.32,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51532.0},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13940.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33141.13},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":40089.2},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13806.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":30730.2},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45603.13},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":56823.32},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14342.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13739.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27349.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14208.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29757.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14329.4,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Soft Tissue Procedures With Mcc","code_information":[{"code":"500","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":27941.7,"maximum":118749.63,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":107691.81},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28350.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":69258.48},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":83778.59},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28078.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":64220.12},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":95301.62},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":118749.63},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29168.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27941.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":55618.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28895.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":60517.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29141.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc Or Insertion Of Antibioti","code_information":[{"code":"492","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":32302.84,"maximum":137765.78,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":124937.2},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32775.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":80349.29},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":97194.6},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32460.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":74504.11},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":110562.89},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":137765.78},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33721.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32302.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":64299.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33405.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":69963.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33689.5,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hip And Femur Procedures Except Major Joint With Cc","code_information":[{"code":"481","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18731.51,"maximum":78589.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":71271.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19005.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45836.04},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":55445.6},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18822.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":42501.59},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":63071.68},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":78589.83},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19553.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18731.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37285.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19371.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":40569.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19535.59,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16979.2,"10th_percentile":16979.2,"90th_percentile":16979.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":1120.0,"10th_percentile":1120.0,"90th_percentile":1120.0},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16346.37,"10th_percentile":16346.37,"90th_percentile":16346.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cervical Spinal Fusion Without Cc/Mcc","code_information":[{"code":"473","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21715.8,"maximum":91602.46,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":83072.56},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22033.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":53425.41},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":64626.09},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21821.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":49538.86},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":73514.87},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":91602.46},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22669.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21715.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":43226.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22457.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":47033.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22647.99,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Wound Debridement Or Skin Graft Except Hand For Musculoskeletal And Connective Tissue Disorders With","code_information":[{"code":"465","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16401.2,"maximum":68428.87,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62056.86},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16641.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39909.85},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":48276.99},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16481.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":37006.52},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":54917.08},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":68428.87},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17121.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16401.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32647.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16961.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":35522.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17105.25,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Single Level Spinal Fusion Except Cervical Without Mcc","code_information":[{"code":"451","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":28506.2,"maximum":121211.07,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":109924.05},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28923.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":70694.07},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":85515.15},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28645.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":65551.28},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":97277.04},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":121211.07},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29757.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28506.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":56742.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29479.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":61740.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29729.88,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc","code_information":[{"code":"442","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9014.45,"maximum":36219.99,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32847.23},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9146.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21124.63},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":25553.42},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9058.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":19587.87},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29068.08},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":36219.99},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9410.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9014.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17943.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9322.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":19523.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9401.42,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.D.E. With Cc","code_information":[{"code":"409","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19444.02,"maximum":81696.65,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":74089.16},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19728.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":47648.03},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":57637.49},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19538.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":44181.77},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":65565.03},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":81696.65},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20297.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19444.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":38704.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20107.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":42112.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20278.69,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":43528.54,"10th_percentile":43528.54,"90th_percentile":43528.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Appendix Procedures With Mcc","code_information":[{"code":"397","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21316.53,"maximum":89861.44,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":81493.66},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21628.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":52409.99},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":63397.79},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21420.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":48597.31},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":72117.62},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":89861.44},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22252.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21316.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":42431.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22044.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":46168.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22231.58,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Gastrointestinal Obstruction With Mcc","code_information":[{"code":"388","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13416.04,"maximum":55412.49,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50252.55},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13612.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32318.29},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":39093.85},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13481.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":29967.23},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":44470.88},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":55412.49},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14005.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13416.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26705.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13874.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29057.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13991.95,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Gastrointestinal Disorders And Peritoneal Infections With Cc","code_information":[{"code":"372","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9493.78,"maximum":38309.96,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34742.59},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9632.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22343.56},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":27027.91},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9540.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":20718.13},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30745.37},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":38309.96},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9910.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9493.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18897.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9817.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":20562.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9901.31,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Digestive System O.R. Procedures With Cc","code_information":[{"code":"357","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":20719.32,"maximum":87257.41,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":79132.11},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21022.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":50891.24},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":61560.64},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20820.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":47189.05},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":70027.78},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":87257.41},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21628.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20719.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":41242.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21426.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":44875.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21608.73,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Anal And Stomal Procedures Without Cc/Mcc","code_information":[{"code":"349","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8199.54,"maximum":32666.65,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29624.78},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8319.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19052.21},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":23046.52},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8239.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":17666.22},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26216.38},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":32666.65},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8559.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8199.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16321.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8479.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17759.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8551.52,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Peritoneal Adhesiolysis With Mcc","code_information":[{"code":"335","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":31436.29,"maximum":133987.31,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":121510.59},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31896.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":78145.58},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":94528.86},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31589.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":72460.7},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":107530.51},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":133987.31},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32816.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31436.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":62575.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32509.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":68086.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32785.75,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Stomach, Esophageal And Duodenal Procedures With Cc","code_information":[{"code":"327","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21740.76,"maximum":91711.27,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":83171.24},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22058.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":53488.87},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":64702.86},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21846.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":49597.71},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":73602.19},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":91711.27},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22695.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21740.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":43275.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22483.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":47087.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22674.02,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Endovascular Cardiac Valve Procedures With Mcc","code_information":[{"code":"319","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":39112.18,"maximum":167456.93,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":151863.56},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39684.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":97666.1},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":118141.89},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39302.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":90561.17},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":134391.31},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":167456.93},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40829.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39112.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":77854.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40447.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":84711.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40791.14,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Angina Pectoris","code_information":[{"code":"311","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6747.84,"maximum":26336.69,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23884.25},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6846.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15360.38},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":18580.7},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6780.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":14242.95},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21136.31},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":26336.69},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7044.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6747.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13431.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6978.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14614.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7037.5,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Atherosclerosis Without Mcc","code_information":[{"code":"303","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6500.87,"maximum":25259.81,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22907.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6596.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14732.31},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":17820.95},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6532.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":13660.57},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20272.07},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":25259.81},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6786.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6500.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12940.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6722.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14079.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6779.93,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Heart Failure And Shock Without Cc/Mcc","code_information":[{"code":"293","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5578.39,"maximum":21237.45,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19259.85},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5660.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12386.34},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":14983.15},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5605.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":11485.27},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17043.96},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":21237.45},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5823.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5578.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11103.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5768.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":12081.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5817.85,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Infectious And Parasitic Diseases With O.R. Procedures Without Cc/Mcc","code_information":[{"code":"855","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13591.59,"maximum":56177.94,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50946.72},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13790.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32764.72},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":39633.88},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13657.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":30381.18},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45085.18},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":56177.94},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14188.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13591.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27054.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14055.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29437.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14175.04,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lymphoma And Leukemia With Major O.R. Procedures With Cc","code_information":[{"code":"821","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19971.52,"maximum":83996.75,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":76175.08},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20263.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":48989.52},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":59260.22},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20068.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":45425.67},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":67410.96},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":83996.75},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20848.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19971.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":39754.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20653.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":43255.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20828.83,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Coagulation Disorders","code_information":[{"code":"813","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13833.4,"maximum":57232.31,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51902.91},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14035.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33379.67},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":40377.74},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13900.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":30951.39},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45931.36},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":57232.31},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14440.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13833.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27535.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14305.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29961.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14427.22,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Vaginal Delivery Without Sterilization Or D&C With Mcc","code_information":[{"code":"805","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9994.6,"maximum":40493.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36723.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10140.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23617.21},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":28568.58},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10043.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":21899.13},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32497.95},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":40493.74},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10433.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9994.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19894.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10335.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":21646.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10423.64,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"1 through 10","median_amount":14181.58,"10th_percentile":14181.58,"90th_percentile":14181.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":11358.4,"10th_percentile":11358.4,"90th_percentile":11358.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":5121.3,"10th_percentile":5121.3,"90th_percentile":5121.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2239.66,"10th_percentile":2239.66,"90th_percentile":2239.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Neonates, Died Or Transferred To Another Acute Care Facility","code_information":[{"code":"789","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16216.19,"maximum":67622.15,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61325.26},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16453.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39439.34},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":47707.84},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16295.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":36570.24},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":54269.65},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":67622.15},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16928.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16216.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32278.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16769.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":35121.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16912.3,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":428.89,"10th_percentile":428.89,"90th_percentile":428.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Postpartum And Post Abortion Diagnoses Without O.R. Procedures","code_information":[{"code":"776","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6341.66,"maximum":24565.65,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22278.13},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6434.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14327.45},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":17331.22},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6372.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":13285.17},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19714.98},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":24565.65},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6620.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6341.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12623.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6558.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":13735.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6613.89,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8105.87,"10th_percentile":8105.87,"90th_percentile":8105.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":2665.48,"10th_percentile":2665.48,"90th_percentile":2665.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Infections, Female Reproductive System With Mcc","code_information":[{"code":"757","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13029.67,"maximum":53727.75,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48724.69},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13220.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31335.7},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":37905.26},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13093.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":29056.11},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":43118.8},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":53727.75},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13601.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13029.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25936.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13474.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":28220.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13588.99,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Vagina, Cervix And Vulva Procedures With Cc/Mcc","code_information":[{"code":"746","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15655.99,"maximum":65179.47,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59110.04},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15885.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":38014.7},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":45984.51},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15732.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":35249.23},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":52309.29},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":65179.47},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16343.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15655.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31163.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16190.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":33908.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16328.06,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy Without Cc/Mcc","code_information":[{"code":"738","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13344.62,"maximum":55101.06,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49970.12},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13539.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32136.65},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":38874.13},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13409.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":29798.8},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":44220.94},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":55101.06},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13930.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13344.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26562.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13800.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":28902.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13917.46,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inflammation Of The Male Reproductive System With Mcc","code_information":[{"code":"727","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13468.53,"maximum":55641.37,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50460.12},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13665.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32451.78},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":39255.33},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13534.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":30091.01},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":44654.57},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":55641.37},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14059.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13468.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26809.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13928.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29170.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14046.69,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Male Reproductive System And Other O.R. Procedures For Malignancy Without Cc/Mcc","code_information":[{"code":"716","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13366.13,"maximum":55194.86,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50055.19},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13561.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32191.36},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":38940.31},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13431.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":29849.53},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":44296.22},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":55194.86},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13952.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13366.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26605.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13822.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":28949.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13939.9,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Male Pelvic Procedures Without Cc/Mcc","code_information":[{"code":"708","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13909.99,"maximum":57566.25,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52205.76},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14113.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33574.43},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":40613.34},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13977.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":31131.99},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46199.36},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":57566.25},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14520.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13909.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27688.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14384.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":30127.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14507.1,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Urinary Stones Without Mcc","code_information":[{"code":"694","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7434.54,"maximum":29330.95,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26599.69},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7543.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17106.72},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":20693.16},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7470.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":15862.26},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23539.33},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":29330.95},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7760.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7434.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14798.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7688.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16102.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7753.68,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"1 through 10","median_amount":2981.06,"10th_percentile":2981.06,"90th_percentile":2981.06},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":2666.62,"10th_percentile":2666.62,"90th_percentile":2666.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Renal Failure With Cc","code_information":[{"code":"683","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8244.29,"maximum":32861.77,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29801.72},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8364.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19166.01},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":23184.18},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8284.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":17771.73},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26372.97},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":32861.77},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8606.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8244.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16410.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8525.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17855.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8598.19,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8131.53,"10th_percentile":8131.53,"90th_percentile":8131.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":2214.42,"10th_percentile":2214.42,"90th_percentile":2214.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":7605.33,"10th_percentile":7605.33,"90th_percentile":7605.33},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":6033.06,"10th_percentile":6033.06,"90th_percentile":6033.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Transurethral Procedures With Cc","code_information":[{"code":"669","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14063.15,"maximum":58234.14,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52811.46},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14268.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33963.97},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":41084.54},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14131.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":31493.18},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46735.38},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":58234.14},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14680.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14063.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27993.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14543.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":30458.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14666.84,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Ureter Procedures For Non-Neoplasm Without Cc/Mcc","code_information":[{"code":"661","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9617.69,"maximum":38850.28,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35232.59},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9758.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22658.69},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":27409.11},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9664.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":21010.34},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31179.0},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":38850.28},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10039.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9617.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19144.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9946.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":20830.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10030.54,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"1 through 10","median_amount":33555.24,"10th_percentile":33555.24,"90th_percentile":33555.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":31398.32,"10th_percentile":31398.32,"90th_percentile":31398.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Bladder Procedures With Mcc","code_information":[{"code":"653","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":45424.13,"maximum":194979.32,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":176823.1},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46088.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":113718.02},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":137559.1},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45645.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":105445.35},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":156479.19},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":194979.32},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47418.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45424.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":90418.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46975.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":98382.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47374.04,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Without Mcc","code_information":[{"code":"641","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7404.42,"maximum":29199.62,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26480.59},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7512.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17030.13},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":20600.51},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7440.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":15791.23},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23433.94},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":29199.62},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7729.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7404.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14738.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7657.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16036.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7722.26,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":11289.95,"10th_percentile":11289.95,"90th_percentile":11289.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16759.89,"10th_percentile":16759.89,"90th_percentile":16759.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":5275.24,"10th_percentile":5275.24,"90th_percentile":5275.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Thyroid, Parathyroid And Thyroglossal Procedures Without Cc/Mcc","code_information":[{"code":"627","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12138.16,"maximum":49840.47,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45199.39},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12315.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29068.52},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":35162.76},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12197.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":26953.86},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39999.1},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":49840.47},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12671.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12138.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24161.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12552.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":26289.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12659.22,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"O.R. Procedures For Obesity With Mcc","code_information":[{"code":"619","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":25554.6,"maximum":108341.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":98252.45},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25928.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":63187.86},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":76435.25},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25679.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":58591.12},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":86948.28},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":108341.02},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26676.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25554.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":50867.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26427.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":55347.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26651.58,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc","code_information":[{"code":"605","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8590.22,"maximum":34370.15,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31169.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8715.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20045.74},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":24248.35},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8632.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":18587.47},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27583.51},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":34370.15},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8967.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8590.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17099.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8883.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":18605.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8958.97,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Mastectomy For Malignancy Without Cc/Mcc","code_information":[{"code":"583","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15546.71,"maximum":64702.94,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":58677.88},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15774.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":37736.77},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":45648.32},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15622.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":34991.52},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":51926.86},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":64702.94},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16229.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15546.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30946.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16077.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":33671.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16214.08,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Graft For Skin Ulcer Or Cellulitis Without Cc/Mcc","code_information":[{"code":"575","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16171.45,"maximum":67427.03,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61148.32},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16408.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39325.55},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":47570.18},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16250.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":36464.72},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":54113.06},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":67427.03},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16881.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16171.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32189.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16723.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":35024.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16865.63,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc","code_information":[{"code":"564","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13990.87,"maximum":57918.96,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52525.62},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14195.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33780.14},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":40862.18},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14059.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":31322.73},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46482.43},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":57918.96},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14605.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13990.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27849.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14468.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":30302.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14591.45,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc","code_information":[{"code":"556","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7855.33,"maximum":31165.77,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28263.66},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7970.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18176.85},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":21987.64},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7893.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":16854.54},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25011.86},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":31165.77},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8200.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7855.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15636.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8123.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17013.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8192.54,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Septic Arthritis With Mcc","code_information":[{"code":"548","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17323.69,"maximum":72451.23,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":65704.67},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17577.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42255.82},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":51114.78},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17408.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":39181.82},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":58145.19},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":72451.23},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18084.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17323.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34483.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17915.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":37520.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18067.34,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Osteomyelitis With Cc","code_information":[{"code":"540","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11862.8,"maximum":48639.77,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44110.5},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12036.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28368.23},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":34315.65},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11920.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":26304.52},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39035.48},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":48639.77},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12383.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11862.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23613.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12267.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":25693.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12372.03,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc","code_information":[{"code":"522","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18931.15,"maximum":79460.34,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":72061.1},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19208.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46343.75},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":56059.75},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19023.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":42972.37},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":63770.3},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":79460.34},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19762.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18931.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37683.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19577.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":41002.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19743.8,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures Without Cc/Mcc","code_information":[{"code":"514","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9504.96,"maximum":38358.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34786.82},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9644.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22372.01},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":27062.33},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9551.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":20744.51},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30784.52},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":38358.74},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9922.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9504.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18919.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9829.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":20586.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9912.98,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Foot Procedures Without Cc/Mcc","code_information":[{"code":"505","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16135.3,"maximum":67269.44,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61005.4},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16371.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39233.64},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":47459.0},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16214.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":36379.5},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":53986.59},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":67269.44},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16843.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16135.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32117.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16686.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":34946.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16827.94,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Without Cc/Mcc","code_information":[{"code":"497","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11105.54,"maximum":45337.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41116.03},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11268.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26442.44},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":31986.12},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11159.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":24518.82},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36385.54},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":45337.83},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11593.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11105.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22105.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11484.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":24052.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11582.26,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Knee Procedures With Principal Diagnosis Of Infection Without Cc/Mcc","code_information":[{"code":"487","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14185.35,"maximum":58766.96,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53294.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14392.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34274.72},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":41460.45},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14254.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":31781.33},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":47162.98},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":58766.96},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14808.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14185.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28236.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14669.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":30723.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14794.29,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Biopsies Of Musculoskeletal System And Connective Tissue With Cc","code_information":[{"code":"478","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21869.84,"maximum":92274.1,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":83681.66},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22189.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":53817.13},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":65099.94},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21976.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":49902.09},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":74053.89},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":92274.1},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22829.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21869.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":43532.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22616.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":47366.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22808.64,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without Mcc","code_information":[{"code":"470","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17306.48,"maximum":72376.19,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":65636.61},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17559.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42212.05},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":51061.84},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17390.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":39141.24},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":58084.97},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":72376.19},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18066.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17306.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34449.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17897.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":37483.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18049.39,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14600.39,"10th_percentile":14600.39,"90th_percentile":14600.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":14191.99,"10th_percentile":14191.99,"90th_percentile":14191.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc","code_information":[{"code":"462","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":23597.78,"maximum":99808.52,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":90514.48},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23943.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":58211.44},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":70415.52},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23712.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":53976.72},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":80100.58},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":99808.52},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24633.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23597.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":46972.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24403.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":51109.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24610.75,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Multiple Level Spinal Fusion Except Cervical With Mcc","code_information":[{"code":"447","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":58204.64,"maximum":250707.0,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":227361.48},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":59056.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":146220.13},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":176875.32},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":58488.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":135583.03},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":201203.02},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":250707.0},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":60759.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":58204.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":115858.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":60192.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":126062.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":60703.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Disorders Of Pancreas Except Malignancy With Cc","code_information":[{"code":"439","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7946.55,"maximum":31563.51,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28624.35},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8062.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18408.82},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":22268.25},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7985.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":17069.63},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25331.06},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":31563.51},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8295.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7946.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15817.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8217.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17211.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8287.67,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7105.64,"10th_percentile":7105.64,"90th_percentile":7105.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"1 through 10","median_amount":20395.89,"10th_percentile":20395.89,"90th_percentile":20395.89},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":4596.62,"10th_percentile":4596.62,"90th_percentile":4596.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc","code_information":[{"code":"430","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":50335.14,"maximum":216393.13,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":196242.88},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51071.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":126207.22},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":152666.67},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50580.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":117025.99},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":173664.68},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":216393.13},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52544.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50335.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":100193.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52053.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":109018.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52495.86,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hepatobiliary Diagnostic Procedures Without Cc/Mcc","code_information":[{"code":"422","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12750.86,"maximum":52512.04,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47622.19},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12937.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30626.66},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":37047.56},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12813.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":28398.65},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42143.14},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":52512.04},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13310.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12750.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25381.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13186.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":27616.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13298.21,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cholecystectomy Except By Laparoscope Without C.D.E. With Mcc","code_information":[{"code":"414","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":31364.87,"maximum":133675.88,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":121228.15},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31823.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":77963.94},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":94309.15},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31517.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":72292.28},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":107280.57},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":133675.88},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32741.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31364.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":62432.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32435.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":67931.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32711.26,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pancreas, Liver And Shunt Procedures With Cc","code_information":[{"code":"406","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":25664.75,"maximum":108821.3,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":98688.01},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26040.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":63467.98},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":76774.09},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25789.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":58850.86},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":87333.72},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":108821.3},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26791.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25664.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":51086.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26541.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":55586.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26766.46,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Digestive System Diagnoses With Mcc","code_information":[{"code":"393","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14470.19,"maximum":60008.93,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":54420.98},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14681.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34999.08},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":42336.67},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14540.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":32453.0},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":48159.72},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":60008.93},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15105.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14470.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28803.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14964.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":31340.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15091.35,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":42571.62,"10th_percentile":42571.62,"90th_percentile":42571.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":13257.5,"10th_percentile":13257.5,"90th_percentile":13257.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inflammatory Bowel Disease With Mcc","code_information":[{"code":"385","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14323.89,"maximum":59371.06,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53842.5},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14533.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34627.05},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":41886.65},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14393.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":32108.03},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":47647.8},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":59371.06},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14952.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14323.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28512.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14813.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":31023.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14938.77,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":32711.94,"10th_percentile":32711.94,"90th_percentile":32711.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Gastrointestinal Hemorrhage With Mcc","code_information":[{"code":"377","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16438.2,"maximum":68590.22,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62203.18},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16678.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40003.95},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":48390.82},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16518.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":37093.78},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":55046.56},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":68590.22},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17159.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16438.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32720.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16999.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":35602.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17143.84,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14916.35,"10th_percentile":14916.35,"90th_percentile":14916.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":15085.2,"10th_percentile":15085.2,"90th_percentile":15085.2},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":11792.42,"10th_percentile":11792.42,"90th_percentile":11792.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Esophageal Disorders With Cc","code_information":[{"code":"369","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9314.78,"maximum":37529.5,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34034.81},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9451.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21888.38},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":26477.29},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9360.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":20296.06},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30119.02},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":37529.5},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9723.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9314.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18541.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9632.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":20174.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9714.63,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hernia Procedures Except Inguinal And Femoral With Cc","code_information":[{"code":"354","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15185.28,"maximum":63127.01,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57248.71},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15407.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36817.64},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":44536.49},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15259.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":34139.26},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":50662.11},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":63127.01},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15851.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15185.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30226.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15703.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":32889.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15837.14,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Minor Small And Large Bowel Procedures Without Cc/Mcc","code_information":[{"code":"346","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10915.36,"maximum":44508.6,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40364.01},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11075.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25958.8},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":31401.09},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10968.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":24070.37},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35720.04},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":44508.6},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11394.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10915.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21727.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11288.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":23641.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11383.92,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Rectal Resection With Mcc","code_information":[{"code":"332","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":31864.83,"maximum":135855.91,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":123205.18},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32331.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":79235.4},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":95847.17},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32020.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":73471.24},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":109030.14},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":135855.91},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33263.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31864.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":63428.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32952.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":69014.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33232.69,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc","code_information":[{"code":"324","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":27822.95,"maximum":118231.82,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":107222.23},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28230.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":68956.48},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":83413.27},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27958.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":63940.09},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":94886.06},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":118231.82},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29044.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27822.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":55382.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28773.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":60260.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29017.3,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Circulatory System Diagnoses Without Cc/Mcc","code_information":[{"code":"316","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6577.46,"maximum":25593.76,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23210.5},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6673.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14927.08},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":18056.55},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6609.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":13841.17},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20540.08},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":25593.76},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6866.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6577.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13092.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6802.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14245.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6859.81,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Arrhythmia And Conduction Disorders With Mcc","code_information":[{"code":"308","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11068.53,"maximum":45176.49,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40969.71},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11230.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26348.34},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":31872.29},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11122.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":24431.57},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36256.05},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":45176.49},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11554.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11068.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22032.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11446.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":23972.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11543.67,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":8490.25,"10th_percentile":8490.25,"90th_percentile":8490.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Percutaneous And Other Intracardiac Procedures Without Mcc","code_information":[{"code":"274","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":29033.71,"maximum":123511.17,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":112009.97},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29458.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":72035.56},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":87137.88},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29175.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":66795.18},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":99122.96},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":123511.17},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30308.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29033.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":57792.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30025.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":62882.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30280.03,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc","code_information":[{"code":"266","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":53444.22,"maximum":229949.82,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":208537.2},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54226.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":134113.91},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":162231.0},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53704.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":124357.49},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":184544.51},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":229949.82},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":55790.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53444.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":106382.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":55269.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":115752.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":55738.41,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Pacemaker Device Replacement With Mcc","code_information":[{"code":"258","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":27746.36,"maximum":117897.88,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":106919.38},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28152.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":68761.72},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":83177.67},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27881.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":63759.49},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":94618.06},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":117897.88},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28964.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27746.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":55230.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28693.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":60094.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28937.42,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc","code_information":[{"code":"250","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19488.77,"maximum":81891.77,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":74266.11},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19773.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":47761.83},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":57775.14},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19583.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":44287.29},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":65721.62},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":81891.77},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20344.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19488.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":38793.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20154.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":42209.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20325.36,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":65721.62,"10th_percentile":65721.62,"90th_percentile":65721.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Coronary Bypass Without Cardiac Catheterization Without Mcc","code_information":[{"code":"236","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":36753.48,"maximum":157172.15,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":142536.49},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37291.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":91667.7},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":110885.91},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36932.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":84999.13},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":126137.33},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":157172.15},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38367.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36753.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":73159.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38008.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":79602.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38331.19,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheterization Without Cc/M","code_information":[{"code":"221","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":44079.98,"maximum":189118.38,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":171507.93},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44725.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":110299.74},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":133424.17},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44295.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":102275.74},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":151775.54},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":189118.38},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46015.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44079.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":87742.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45585.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":95470.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45972.2,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Concomitant Aortic And Mitral Valve Procedures","code_information":[{"code":"212","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":94282.13,"maximum":408017.98,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":370023.87},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":95661.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":237968.8},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":287859.18},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":94742.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":220657.24},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":327451.77},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":408017.98},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":98421.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":94282.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":187672.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":97501.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":204201.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":98329.37,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Bronchitis And Asthma With Cc/Mcc","code_information":[{"code":"202","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9065.23,"maximum":36441.37,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33047.99},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9197.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21253.74},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":25709.61},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9109.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":19707.59},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29245.75},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":36441.37},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9463.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9065.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18044.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9374.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":19633.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9454.37,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":29245.75,"10th_percentile":29245.75,"90th_percentile":29245.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Simple Pneumonia And Pleurisy With Cc","code_information":[{"code":"194","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7642.78,"maximum":30238.98,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27423.17},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7754.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17636.32},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":21333.78},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7680.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":16353.32},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24268.07},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":30238.98},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7978.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7642.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15213.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7903.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16553.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7970.86,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pleural Effusion With Mcc","code_information":[{"code":"186","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14119.09,"maximum":58478.04,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53032.64},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14325.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34106.21},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":41256.61},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14187.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":31625.08},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46931.11},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":58478.04},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14738.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14119.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28104.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14601.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":30579.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14725.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"1 through 10","median_amount":42184.53,"10th_percentile":42184.53,"90th_percentile":42184.53},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Respiratory Infections And Inflammations With Cc","code_information":[{"code":"178","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9106.53,"maximum":36621.47,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33211.33},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9239.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21358.78},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":25836.67},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9150.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":19804.99},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29390.29},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":36621.47},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9506.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9106.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18126.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9417.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":19723.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9497.44,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Non-Extensive O.R. Procedures Unrelated To Principal Diagnosis With Cc","code_information":[{"code":"988","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14851.4,"maximum":61671.16,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55928.42},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15068.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35968.54},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":43509.38},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14923.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":33351.93},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":49493.73},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":61671.16},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15503.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14851.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29562.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15358.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":32165.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15488.92,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":11836.13,"10th_percentile":11836.13,"90th_percentile":11836.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hiv With Major Related Condition With Mcc","code_information":[{"code":"974","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":25542.56,"maximum":108288.49,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":98204.81},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25916.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":63157.22},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":76398.19},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25667.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":58562.71},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":86906.12},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":108288.49},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26663.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25542.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":50843.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26414.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":55321.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26639.02,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other O.R. Procedures For Multiple Significant Trauma With Mcc","code_information":[{"code":"957","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":66278.94,"maximum":285913.89,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":259289.96},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":67248.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":166753.89},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":201713.99},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":66602.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":154623.01},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":229458.05},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":285913.89},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":69188.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":66278.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":131930.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":68542.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":143550.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":69124.08,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Rehabilitation Without Cc/Mcc","code_information":[{"code":"946","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10576.31,"maximum":43030.23,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39023.31},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10731.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25096.57},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":30358.09},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10627.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":23270.87},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34533.59},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":43030.23},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11040.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10576.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21052.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10937.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":22906.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11030.32,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc","code_information":[{"code":"929","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":28423.6,"maximum":120850.86,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":109597.38},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28839.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":70483.99},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":85261.02},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28562.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":65356.47},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":96987.95},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":120850.86},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29671.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28423.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":56578.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29394.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":61561.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29643.73,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Poisoning And Toxic Effects Of Drugs Without Mcc","code_information":[{"code":"918","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8083.38,"maximum":32160.11,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29165.4},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8201.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18756.78},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":22689.15},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8122.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":17392.27},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25809.85},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":32160.11},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8438.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8083.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16090.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8359.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17507.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8430.37,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":1285.06,"10th_percentile":1285.06,"90th_percentile":1285.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":5783.43,"10th_percentile":5783.43,"90th_percentile":5783.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other O.R. Procedures For Injuries With Mcc","code_information":[{"code":"907","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":33745.94,"maximum":144058.21,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":130643.7},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34239.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":84019.24},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":101633.95},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33910.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":77907.08},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":115612.84},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":144058.21},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35227.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33745.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":67172.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34898.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":73088.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35194.55,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc","code_information":[{"code":"896","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15724.83,"maximum":65479.64,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59382.26},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15954.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":38189.77},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":46196.29},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15801.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":35411.57},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":52550.2},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":65479.64},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16415.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15724.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31300.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16261.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":34057.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16399.85,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14269.98,"10th_percentile":14269.98,"90th_percentile":14269.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":33506.72,"10th_percentile":33506.72,"90th_percentile":33506.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Neuroses Except Depressive","code_information":[{"code":"882","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9948.13,"maximum":40291.12,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36539.27},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10093.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23499.04},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":28425.63},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9996.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":21789.55},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32335.34},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":40291.12},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10384.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9948.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19802.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10287.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":21546.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10375.17,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Infectious And Parasitic Diseases Diagnoses With Cc","code_information":[{"code":"868","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9580.69,"maximum":38688.93,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35086.27},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9720.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22564.59},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":27295.28},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9627.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":20923.08},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31049.51},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":38688.93},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10001.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9580.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19070.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9907.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":20750.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9991.95,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2193.31,"10th_percentile":2193.31,"90th_percentile":2193.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Postoperative Or Post-Traumatic Infections With O.R. Procedures With Cc","code_information":[{"code":"857","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19135.95,"maximum":80353.36,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":72870.96},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19415.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46864.59},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":56689.79},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19229.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":43455.32},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":64486.99},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":80353.36},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19976.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19135.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":38090.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19789.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":41445.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19957.4,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Cc","code_information":[{"code":"847","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11965.19,"maximum":49086.28,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44515.43},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12140.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28628.65},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":34630.67},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12023.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":26545.99},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39393.83},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":49086.28},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12490.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11965.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23817.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12373.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":25914.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12478.82,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Chemotherapy With Acute Leukemia As Secondary Diagnosis Without Cc/Mcc","code_information":[{"code":"839","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13132.94,"maximum":54178.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49133.03},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13325.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31598.31},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":38222.92},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13197.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":29299.62},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":43480.16},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":54178.02},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13709.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13132.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26141.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13581.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":28444.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13696.69,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Antepartum Diagnoses Without O.R. Procedures With Mcc","code_information":[{"code":"831","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11055.62,"maximum":45120.21,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40918.67},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11217.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26315.51},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":31832.58},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11109.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":24401.13},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36210.88},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":45120.21},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11540.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11055.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22006.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11433.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":23944.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11530.2,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":6543.02,"10th_percentile":6543.02,"90th_percentile":6543.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lymphoma And Non-Acute Leukemia With Other Procedures With Mcc","code_information":[{"code":"823","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":40161.15,"maximum":172030.87,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":156011.57},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40748.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":100333.76},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":121368.83},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40357.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":93034.76},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":138062.08},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":172030.87},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41924.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40161.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":79942.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41532.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":86983.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41885.14,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Reticuloendothelial And Immunity Disorders With Cc","code_information":[{"code":"815","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9433.54,"maximum":38047.31,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34504.39},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9571.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22190.38},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":26842.61},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9479.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":20576.09},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30534.58},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":38047.31},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9847.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9433.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18777.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9755.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":20431.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9838.49,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Vaginal Delivery Without Sterilization Or D&C Without Cc/Mcc","code_information":[{"code":"807","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6509.47,"maximum":25297.33,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22941.68},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6604.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14754.19},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":17847.42},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6541.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":13680.87},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20302.18},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":25297.33},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6795.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6509.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12957.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6731.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14098.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6788.9,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"1 through 10","median_amount":9580.38,"10th_percentile":9580.38,"90th_percentile":11971.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":1933.4,"10th_percentile":1933.4,"90th_percentile":1933.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":19670.79,"10th_percentile":19670.79,"90th_percentile":19670.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"1 through 10","median_amount":9872.5,"10th_percentile":9872.5,"90th_percentile":9872.5},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2260.99,"10th_percentile":1951.81,"90th_percentile":2260.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14553.54,"10th_percentile":13006.69,"90th_percentile":14787.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"20","median_amount":2025.46,"10th_percentile":2025.46,"90th_percentile":2346.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":12817.51,"10th_percentile":12817.51,"90th_percentile":12921.16},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2239.66,"10th_percentile":2239.66,"90th_percentile":2239.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Splenic Procedures With Mcc","code_information":[{"code":"799","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":39680.12,"maximum":169933.39,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":154109.41},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40260.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":99110.45},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":119889.04},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39873.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":91900.44},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":136378.77},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":169933.39},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41422.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39680.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":78984.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41035.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":85941.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41383.46,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Chest Procedures Without Cc/Mcc","code_information":[{"code":"165","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17179.98,"maximum":71824.61,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":65136.4},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17431.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":41890.35},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":50672.7},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17263.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":38842.95},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":57642.3},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":71824.61},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17934.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17179.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34197.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17766.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":37209.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17917.47,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Ear, Nose, Mouth And Throat Diagnoses With Mcc","code_information":[{"code":"154","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14162.12,"maximum":58665.65,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53202.78},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14369.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34215.63},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":41388.97},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14231.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":31726.54},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":47081.68},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":58665.65},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14783.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14162.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28190.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14645.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":30673.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14770.05,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ear, Nose, Mouth And Throat Malignancy With Mcc","code_information":[{"code":"146","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18928.56,"maximum":79449.08,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":72050.89},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19205.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46337.18},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":56051.81},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19020.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":42966.28},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":63761.27},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":79449.08},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19759.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18928.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37678.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19574.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":40996.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19741.11,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Mouth Procedures Without Cc/Mcc","code_information":[{"code":"138","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8333.78,"maximum":33252.0,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30155.61},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8455.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19393.6},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":23459.49},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8374.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":17982.77},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26686.14},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":33252.0},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8699.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8333.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16588.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8618.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":18049.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8691.53,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Major Eye Infections With Cc/Mcc","code_information":[{"code":"121","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10718.3,"maximum":43649.34,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39584.77},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10875.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25457.66},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":30794.88},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10770.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":23605.68},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35030.45},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":43649.34},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11188.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10718.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21335.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11084.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":23214.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11178.4,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Seizures Without Mcc","code_information":[{"code":"101","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8474.92,"maximum":33867.36,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30713.67},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8598.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19752.5},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":23893.63},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8516.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":18315.56},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27179.99},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":33867.36},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8846.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8474.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16869.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8764.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":18355.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8838.72,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Disorders Of Nervous System Without Cc/Mcc","code_information":[{"code":"093","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7560.17,"maximum":29878.77,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27096.5},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7670.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17426.23},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":21079.65},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7597.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":16158.52},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23978.98},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":29878.77},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7892.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7560.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15048.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7818.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16374.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7884.71,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Traumatic Stupor And Coma <1 Hour With Mcc","code_information":[{"code":"085","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":20258.08,"maximum":85246.23,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":77308.21},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20554.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":49718.26},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":60141.74},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20356.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":46101.39},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":68413.72},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":85246.23},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21147.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20258.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":40324.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20949.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":43876.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21127.69,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cranial And Peripheral Nerve Disorders Without Mcc","code_information":[{"code":"074","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9578.1,"maximum":38677.68,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35076.06},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9718.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22558.03},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":27287.34},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9624.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":20916.99},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31040.48},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":38677.68},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9998.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9578.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19065.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9905.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":20744.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9989.26,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Intracranial Hemorrhage Or Cerebral Infarction Without Cc/Mcc","code_information":[{"code":"066","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6597.25,"maximum":25680.06,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23288.76},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6693.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14977.41},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":18117.44},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6629.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":13887.84},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20609.34},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":25680.06},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6886.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6597.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13132.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6822.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14288.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6880.45,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":18117.44,"10th_percentile":18117.44,"90th_percentile":18117.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3000.0,"10th_percentile":3000.0,"90th_percentile":3000.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Multiple Sclerosis And Cerebellar Ataxia With Mcc","code_information":[{"code":"058","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15418.48,"maximum":64143.86,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":58170.87},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15644.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":37410.7},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":45253.88},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15493.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":34689.17},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":51478.17},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":64143.86},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16095.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15418.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30691.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15944.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":33394.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16080.35,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Peripheral Neurostimulator","code_information":[{"code":"041","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19628.18,"maximum":82499.62,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":74817.36},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19915.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":48116.35},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":58203.99},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19723.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":44616.02},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":66209.45},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":82499.62},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20489.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19628.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":39070.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20298.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":42511.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20470.75,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ventricular Shunt Procedures Without Cc/Mcc","code_information":[{"code":"033","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15017.48,"maximum":62395.33,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56585.16},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15237.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36390.9},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":44020.29},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15090.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":33743.57},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":50074.91},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":62395.33},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15676.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15017.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29892.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15530.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":32525.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15662.13,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Craniotomy And Endovascular Intracranial Procedures With Mcc","code_information":[{"code":"025","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":39833.29,"maximum":170601.28,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":154715.11},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40416.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":99499.98},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":120360.24},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40027.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":92261.64},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":136914.78},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":170601.28},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41582.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39833.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":79289.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41193.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":86273.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41543.21,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Autologous Bone Marrow Transplant Without Cc/Mcc","code_information":[{"code":"017","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":47454.1,"maximum":203830.76,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":184850.3},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48148.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":118880.45},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":143803.85},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47685.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":110232.23},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":163582.85},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":203830.76},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49537.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47454.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":94459.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49074.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":102778.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49491.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lung Transplant","code_information":[{"code":"007","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":112147.49,"maximum":485917.4,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":440669.41},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":113788.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":283402.18},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":342817.69},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":112694.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":262785.46},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":389969.37},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":485917.4},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":117071.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":112147.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":223233.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":115976.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":242895.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":116961.63,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Myocardial Infarction, Expired Without Cc/Mcc","code_information":[{"code":"285","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5861.49,"maximum":22471.93,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20379.37},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5947.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13106.33},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":15854.08},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5890.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":12152.88},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18034.68},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":22471.93},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6118.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5861.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11667.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6061.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":12695.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6113.11,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Defibrillator Implant Without Mcc","code_information":[{"code":"277","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":40451.15,"maximum":173295.36,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":157158.32},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41043.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":101071.25},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":122260.93},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40648.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":93718.6},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":139076.89},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":173295.36},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42227.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40451.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":80519.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41832.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":87611.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42187.59,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc","code_information":[{"code":"269","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":37049.5,"maximum":158462.91,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":143707.05},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37591.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":92420.51},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":111796.55},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37230.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":85697.17},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":127173.22},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":158462.91},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38676.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37049.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":73748.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38314.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":80243.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38639.91,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Pacemaker Revision Except Device Replacement With Cc","code_information":[{"code":"261","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16976.04,"maximum":70935.34,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":64329.93},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17224.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":41371.7},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":50045.32},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17058.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":38362.03},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":56928.63},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":70935.34},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17721.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16976.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":33791.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17555.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":36767.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17704.77,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"1 through 10","median_amount":26864.01,"10th_percentile":26864.01,"90th_percentile":26864.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15394.02,"10th_percentile":15394.02,"90th_percentile":15394.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Vascular Procedures With Cc","code_information":[{"code":"253","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":23043.6,"maximum":97392.1,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":88323.08},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23380.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":56802.11},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":68710.72},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23156.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":52669.92},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":78161.3},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":97392.1},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24055.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23043.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":45869.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23830.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":49909.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24032.79,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":52669.92,"10th_percentile":52669.92,"90th_percentile":52669.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":21115.01,"10th_percentile":21115.01,"90th_percentile":21115.01},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":19505.71,"10th_percentile":19505.71,"90th_percentile":19505.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc/Mcc","code_information":[{"code":"241","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12620.92,"maximum":51945.46,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47108.36},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12805.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30296.21},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":36647.84},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12682.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":28092.24},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":41688.44},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":51945.46},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13175.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12620.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25122.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13051.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":27335.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13162.69,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Coronary Bypass With Ptca With Mcc","code_information":[{"code":"231","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":73249.2,"maximum":316306.71,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":286852.64},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":74321.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":184479.93},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":223156.31},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":73606.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":171059.53},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":253849.58},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":316306.71},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":76465.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":73249.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":145805.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":75750.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":158647.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":76393.55,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With Mcc","code_information":[{"code":"216","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":84891.23,"maximum":367070.22,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":332889.12},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":86133.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":214086.8},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":258970.28},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":85305.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":198512.58},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":294589.46},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":367070.22},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":88618.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":84891.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":168979.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":87789.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":183861.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":88535.34,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Respiratory System Diagnoses With Mcc","code_information":[{"code":"205","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16464.02,"maximum":68702.78,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62305.27},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16704.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40069.6},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":48470.23},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16544.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":37154.65},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":55136.9},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":68702.78},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17186.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16464.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32772.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17026.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":35658.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17170.77,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Interstitial Lung Disease With Cc","code_information":[{"code":"197","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8875.05,"maximum":35612.13,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32295.97},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9004.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20770.1},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":25124.58},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8918.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":19259.14},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28580.25},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":35612.13},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9264.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8875.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17666.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9178.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":19222.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9256.03,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pulmonary Edema And Respiratory Failure","code_information":[{"code":"189","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11338.73,"maximum":46354.68,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42038.19},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11504.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27035.49},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":32703.51},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11394.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":25068.74},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":37201.6},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":46354.68},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11836.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11338.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22570.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11725.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":24558.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11825.47,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"1 through 10","median_amount":56055.97,"10th_percentile":56055.97,"90th_percentile":56055.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":4877.48,"10th_percentile":4877.48,"90th_percentile":4877.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":38819.41,"10th_percentile":38819.41,"90th_percentile":38819.41},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":10415.12,"10th_percentile":10415.12,"90th_percentile":10415.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Respiratory Neoplasms With Cc","code_information":[{"code":"181","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9924.03,"maximum":40186.06,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36443.99},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10069.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23437.76},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":28351.51},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9972.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":21732.73},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32251.02},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":40186.06},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10359.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9924.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19754.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10262.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":21494.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10350.04,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Respiratory System O.R. Procedures Without Cc/Mcc","code_information":[{"code":"168","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12466.02,"maximum":51270.06,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46495.86},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12648.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29902.3},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":36171.34},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12526.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":27726.99},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":41146.4},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":51270.06},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13013.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12466.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24814.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12891.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":26999.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13001.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Dental And Oral Diseases With Mcc","code_information":[{"code":"157","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15481.3,"maximum":64417.77,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":58419.27},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15707.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":37570.45},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":45447.13},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15556.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":34837.31},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":51698.0},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":64417.77},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16160.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15481.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30816.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16009.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":33530.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16145.87,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Dysequilibrium","code_information":[{"code":"149","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7175.52,"maximum":28201.54,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25575.44},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7280.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16448.01},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":19896.36},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7210.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":15251.47},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22632.93},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":28201.54},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7490.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7175.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14283.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7420.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":15541.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7483.55,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"1 through 10","median_amount":3286.81,"10th_percentile":3286.81,"90th_percentile":3286.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":26726.62,"10th_percentile":26726.62,"90th_percentile":26726.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":5058.65,"10th_percentile":5058.65,"90th_percentile":5058.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Head And Neck Procedures With Cc","code_information":[{"code":"141","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19476.72,"maximum":81839.23,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":74218.47},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19761.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":47731.19},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":57738.08},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19571.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":44258.88},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":65679.46},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":81839.23},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20331.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19476.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":38769.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20141.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":42183.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20312.8,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Disorders Of The Eye With Mcc Or Thrombolytic Agent","code_information":[{"code":"124","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12093.42,"maximum":49645.36,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45022.45},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12270.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28954.72},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":35025.1},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12152.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":26848.35},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39842.51},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":49645.36},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12624.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12093.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24072.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12506.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":26192.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12612.55,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Orbital Procedures With Cc/Mcc","code_information":[{"code":"113","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":20939.61,"maximum":88217.97,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":80003.23},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21246.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":51451.47},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":62238.32},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21041.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":47708.52},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":70798.67},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":88217.97},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21858.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20939.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":41681.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21654.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":45352.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21838.48,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc","code_information":[{"code":"096","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":22902.47,"maximum":96776.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":87765.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23237.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":56443.21},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":68276.58},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23014.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":52337.13},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":77667.45},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":96776.74},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23907.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22902.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":45588.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23684.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":49603.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23885.6,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Concussion With Mcc","code_information":[{"code":"088","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12340.38,"maximum":50722.24,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45999.05},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12520.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29582.79},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":35784.85},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12400.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":27430.73},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40706.75},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":50722.24},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12882.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12340.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24563.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12761.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":26727.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12870.12,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Nontraumatic Stupor And Coma With Mcc","code_information":[{"code":"080","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16283.31,"maximum":67914.82,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61590.68},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16521.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39610.04},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":47914.32},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16362.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":36728.52},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":54504.53},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":67914.82},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16998.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16283.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32412.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16839.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":35267.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16982.31,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Transient Ischemia Without Thrombolytic","code_information":[{"code":"069","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7581.69,"maximum":29972.57,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27181.57},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7692.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17480.94},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":21145.83},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7618.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":16209.25},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24054.26},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":29972.57},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7914.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7581.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15091.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7840.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16420.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7907.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5926.86,"10th_percentile":5926.86,"90th_percentile":5926.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic Agent With Mcc","code_information":[{"code":"061","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":24433.35,"maximum":103451.91,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":93818.6},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24790.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":60336.38},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":72985.95},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24552.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":55947.07},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":83024.55},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":103451.91},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25506.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24433.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":48635.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25267.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":52919.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25482.19,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":20792.34,"10th_percentile":20792.34,"90th_percentile":20792.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Spinal Disorders And Injuries Without Cc/Mcc","code_information":[{"code":"053","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9134.07,"maximum":36741.54,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33320.22},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9267.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21428.81},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":25921.38},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9178.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":19869.93},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29486.65},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":36741.54},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9535.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9134.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18181.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9445.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":19783.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9526.17,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Carotid Artery Stent Procedures Without Cc/Mcc","code_information":[{"code":"036","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17426.09,"maximum":72897.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":66109.6},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17681.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42516.24},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":51429.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17511.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":39423.3},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":58503.54},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":72897.74},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18191.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17426.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34687.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18021.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":37742.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18174.13,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15805.91,"10th_percentile":15805.91,"90th_percentile":15805.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Spinal Procedures With Mcc","code_information":[{"code":"028","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":52410.72,"maximum":225443.43,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":204450.43},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53177.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":131485.64},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":159051.72},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52666.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":121920.42},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":180927.94},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":225443.43},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54711.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52410.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":104325.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54200.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":113513.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54660.55,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc","code_information":[{"code":"020","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":68420.79,"maximum":295253.11,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":267759.53},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":69422.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":172200.82},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":208302.87},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":68754.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":159673.69},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":236953.17},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":295253.11},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":71424.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":68420.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":136194.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":70757.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":148189.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":71357.88,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc","code_information":[{"code":"011","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":47641.69,"maximum":204648.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":185592.11},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48338.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":119357.52},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":144380.94},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47874.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":110674.6},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":164239.31},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":204648.74},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49733.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47641.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":94832.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49268.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":103184.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49686.8,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Heart Transplant Or Implant Of Heart Assist System Without Mcc","code_information":[{"code":"002","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":98220.76,"maximum":425191.8,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":385598.49},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":99658.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":247985.11},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":299975.41},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":98699.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":229944.89},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":341234.49},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":425191.8},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":102532.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":98220.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":195512.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":101574.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":212731.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":102437.06,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Infections, Female Reproductive System Without Cc/Mcc","code_information":[{"code":"759","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6418.25,"maximum":24899.6,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22580.98},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6512.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14522.22},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":17566.82},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6449.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":13465.77},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19982.99},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":24899.6},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6700.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6418.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12775.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6637.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":13901.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6693.77,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cesarean Section With Sterilization With Mcc","code_information":[{"code":"783","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21834.56,"maximum":92120.26,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":83542.14},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22154.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":53727.41},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":64991.41},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21941.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":49818.89},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":73930.43},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":92120.26},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22793.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21834.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":43462.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22580.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":47290.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22771.85,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Prematurity With Major Problems","code_information":[{"code":"791","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":35636.51,"maximum":152301.8,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":138119.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36158.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":88827.16},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":107449.85},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35810.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":82365.23},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":122228.67},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":152301.8},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37201.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35636.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":70935.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36853.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":77183.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37166.28,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Female Reproductive System Reconstructive Procedures","code_information":[{"code":"748","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12645.88,"maximum":52054.27,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47207.04},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12830.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30359.67},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":36724.61},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12707.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":28151.09},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":41775.76},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":52054.27},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13201.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12645.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25172.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13077.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":27389.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13188.72,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy With Cc","code_information":[{"code":"740","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16279.87,"maximum":67899.81,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61577.07},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16518.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39601.29},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":47903.73},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16359.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":36720.4},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":54492.48},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":67899.81},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16994.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16279.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32405.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16835.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":35259.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16978.71,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Male Reproductive System Diagnoses With Cc/Mcc","code_information":[{"code":"729","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9818.19,"maximum":39724.54,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36025.44},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9961.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23168.59},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":28025.91},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9866.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":21483.14},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31880.63},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":39724.54},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10249.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9818.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19543.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10153.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":21264.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10239.65,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Male Reproductive System O.R. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":25589.19,"10th_percentile":25589.19,"90th_percentile":25589.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Penis Procedures Without Cc/Mcc","code_information":[{"code":"710","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12765.48,"maximum":52575.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47680.03},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12952.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30663.86},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":37092.57},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12827.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":28433.15},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42194.34},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":52575.83},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13325.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12765.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25410.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13201.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":27648.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13313.46,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Urinary Tract Signs And Symptoms Without Mcc","code_information":[{"code":"696","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6636.83,"maximum":25852.66,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23445.29},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6733.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15078.08},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":18239.21},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6669.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":13981.19},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20747.86},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":25852.66},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6928.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6636.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13210.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6863.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14374.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6921.73,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":15078.08,"10th_percentile":15078.08,"90th_percentile":15078.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Urinary Tract Neoplasms With Mcc","code_information":[{"code":"686","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16229.1,"maximum":67678.43,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61376.3},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16466.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39472.17},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":47747.55},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16308.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":36600.68},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":54314.82},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":67678.43},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16941.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16229.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32304.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16783.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":35149.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16925.77,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Urethral Procedures With Cc/Mcc","code_information":[{"code":"671","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16154.24,"maximum":67351.99,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61080.26},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16390.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39281.78},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":47517.24},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16233.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":36424.14},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":54052.84},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":67351.99},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16863.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16154.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32155.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16705.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":34987.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16847.69,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Minor Bladder Procedures With Cc","code_information":[{"code":"663","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13789.51,"maximum":57040.94,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51729.37},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13991.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33268.06},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":40242.73},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13856.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":30847.9},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45777.78},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":57040.94},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14394.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13789.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27448.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14260.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29866.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14381.45,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Bladder Procedures Without Cc/Mcc","code_information":[{"code":"655","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18921.68,"maximum":79419.07,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":72023.66},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19198.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46319.67},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":56030.64},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19013.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":42950.05},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":63737.18},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":79419.07},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19752.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18921.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37664.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19567.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":40981.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19733.93,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Endocrine Disorders With Mcc","code_information":[{"code":"643","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14872.91,"maximum":61764.96,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56013.49},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15090.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36023.25},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":43575.56},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14945.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":33402.66},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":49569.01},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":61764.96},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15525.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14872.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29605.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15380.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":32212.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15511.36,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13526.5,"10th_percentile":13526.5,"90th_percentile":13526.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":29055.41,"10th_percentile":29055.41,"90th_percentile":29055.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":9601.04,"10th_percentile":9601.04,"90th_percentile":9601.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Endocrine, Nutritional And Metabolic O.R. Procedures With Cc","code_information":[{"code":"629","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19456.93,"maximum":81752.93,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":74140.21},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19741.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":47680.86},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":57677.19},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19551.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":44212.21},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":65610.2},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":81752.93},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20311.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19456.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":38729.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20121.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":42140.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20292.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"O.R. Procedures For Obesity Without Cc/Mcc","code_information":[{"code":"621","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13687.97,"maximum":56598.18,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51327.84},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13888.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33009.83},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":39930.36},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13754.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":30608.45},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45422.45},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":56598.18},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14288.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13687.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27246.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14155.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29646.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14275.55,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Minor Skin Disorders Without Mcc","code_information":[{"code":"607","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8507.61,"maximum":34009.94,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30842.98},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8632.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19835.66},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":23994.22},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8549.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":18392.67},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27294.42},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":34009.94},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8881.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8507.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16934.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8798.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":18426.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8872.82,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":6155.52,"10th_percentile":6155.52,"90th_percentile":6155.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignant Breast Disorders Without Cc/Mcc","code_information":[{"code":"599","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7328.69,"maximum":28869.43,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26181.14},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7435.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16837.55},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":20367.56},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7364.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":15612.66},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23168.94},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":28869.43},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7650.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7328.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14588.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7578.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":15872.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7643.29,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Breast Biopsy, Local Excision And Other Breast Procedures Without Cc/Mcc","code_information":[{"code":"585","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17308.2,"maximum":72383.69,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":65643.41},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17561.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42216.42},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":51067.14},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17392.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":39145.3},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":58090.99},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":72383.69},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18068.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17308.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34452.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17899.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":37487.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18051.19,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Graft Except For Skin Ulcer Or Cellulitis With Cc","code_information":[{"code":"577","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":23517.74,"maximum":99459.57,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":90198.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23861.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":58007.92},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":70169.33},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23632.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":53788.0},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":79820.53},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":99459.57},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24550.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23517.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":46812.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24320.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":50935.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24527.29,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Musculoskeletal System And Connective Tissue Diagnoses Without Cc/Mcc","code_information":[{"code":"566","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7155.73,"maximum":28115.23,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25497.18},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7260.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16397.68},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":19835.47},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7190.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":15204.8},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22563.67},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":28115.23},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7469.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7155.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14243.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7400.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":15498.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7462.9,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Tendonitis, Myositis And Bursitis Without Mcc","code_information":[{"code":"558","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8394.02,"maximum":33514.65,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30393.81},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8516.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19546.79},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":23644.79},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8434.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":18124.81},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26896.93},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":33514.65},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8762.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8394.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16708.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8680.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":18180.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8754.35,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Septic Arthritis Without Cc/Mcc","code_information":[{"code":"550","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8229.66,"maximum":32797.98,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29743.87},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8350.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19128.8},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":23139.18},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8269.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":17737.24},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26321.77},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":32797.98},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8590.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8229.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16381.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8510.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17824.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8582.94,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With Mcc","code_information":[{"code":"542","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15908.98,"maximum":66282.61,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":60110.46},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16141.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":38658.09},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":46762.79},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15986.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":35845.82},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":53194.61},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":66282.61},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16607.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15908.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31667.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16452.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":34456.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16591.91,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Fractures Of Femur Without Mcc","code_information":[{"code":"534","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7644.5,"maximum":30246.48,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27429.97},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7756.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17640.69},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":21339.08},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7681.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":16357.38},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24274.09},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":30246.48},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7980.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7644.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15216.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7905.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16556.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7972.66,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Musculoskeletal System And Connective Tissue O.R. Procedures With Cc","code_information":[{"code":"516","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18590.38,"maximum":77974.47,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":70713.59},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18862.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45477.14},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":55011.46},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18681.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":42168.81},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":62577.83},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":77974.47},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19406.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18590.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37004.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19225.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":40264.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19388.41,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":17036.18,"10th_percentile":17036.18,"90th_percentile":17036.18},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Shoulder Or Elbow Joint Procedures With Cc/Mcc","code_information":[{"code":"507","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16252.33,"maximum":67779.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61468.18},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16490.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39531.26},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":47819.02},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16331.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":36655.47},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":54396.12},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":67779.74},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16965.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16252.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32350.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16807.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":35200.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16949.99,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur Without Cc/Mcc","code_information":[{"code":"499","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18045.67,"maximum":75599.33,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":68559.61},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18309.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":44091.88},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":53335.79},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18133.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":40884.32},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":60671.67},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":75599.33},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18837.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18045.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":35920.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18661.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":39084.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18820.31,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Knee Procedures Without Principal Diagnosis Of Infection Without Cc/Mcc","code_information":[{"code":"489","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10318.15,"maximum":41904.57,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38002.47},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10469.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24440.05},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":29563.93},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10368.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":22662.11},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33630.2},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":41904.57},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10771.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10318.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20538.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10670.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":22347.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10761.08,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hip And Femur Procedures Except Major Joint With Mcc Or Insertion Of Antibiotic-Eluting Bone Void Fi","code_information":[{"code":"480","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":25768.88,"maximum":109275.32,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":99099.74},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26145.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":63732.77},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":77094.41},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25894.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":59096.39},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":87698.09},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":109275.32},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26900.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25768.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":51293.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26648.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":55811.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26875.06,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":21907.01,"10th_percentile":21907.01,"90th_percentile":21907.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cervical Spinal Fusion With Cc","code_information":[{"code":"472","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":26059.73,"maximum":110543.56,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":100249.89},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26441.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":64472.45},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":77989.16},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26186.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":59782.26},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":88715.91},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":110543.56},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27203.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26059.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":51872.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26949.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":56441.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27178.39,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Wound Debridement Or Skin Graft Except Hand For Musculoskeletal And Connective Tissue Disorders With","code_information":[{"code":"464","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":27510.58,"maximum":116869.77,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":105987.01},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27913.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":68162.09},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":82452.34},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27644.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":63203.49},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":93792.96},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":116869.77},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28718.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27510.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":54760.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28449.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":59583.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28691.52,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":61774.79,"10th_percentile":61774.79,"90th_percentile":61774.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Single Level Spinal Fusion Except Cervical With Mcc","code_information":[{"code":"450","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":46570.34,"maximum":199977.25,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":181355.63},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47251.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":116632.97},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":141085.17},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46797.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":108148.24},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":160490.24},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":199977.25},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48614.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46570.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":92699.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48160.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":100864.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48569.46,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc","code_information":[{"code":"441","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16151.65,"maximum":67340.73,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61070.05},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16388.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39275.21},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":47509.3},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16230.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":36418.05},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":54043.8},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":67340.73},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16860.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16151.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32150.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16703.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":34982.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16844.99,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cirrhosis And Alcoholic Hepatitis With Cc","code_information":[{"code":"433","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9796.67,"maximum":39630.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35940.37},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9940.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23113.88},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":27959.73},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9844.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":21432.41},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31805.35},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":39630.74},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10226.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9796.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19500.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10131.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":21218.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10217.21,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":37626.43,"10th_percentile":37626.43,"90th_percentile":37626.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Hepatobiliary Or Pancreas O.R. Procedures With Cc","code_information":[{"code":"424","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19535.24,"maximum":82094.38,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":74449.86},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19821.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":47880.0},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":57918.09},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19630.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":44396.87},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":65884.23},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":82094.38},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20392.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19535.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":38885.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20202.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":42310.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20373.83,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cholecystectomy Except By Laparoscope Without C.D.E. Without Cc/Mcc","code_information":[{"code":"416","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12439.35,"maximum":51153.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46390.37},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12621.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29834.46},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":36089.28},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12500.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":27664.08},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":41053.05},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":51153.74},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12985.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12439.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24760.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12864.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":26941.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12973.33,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.D.E. With Mcc","code_information":[{"code":"408","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":31390.69,"maximum":133788.44,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":121330.24},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31850.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":78029.59},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":94388.56},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31543.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":72353.16},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":107370.91},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":133788.44},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32768.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31390.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":62484.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32462.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":67987.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32738.19,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Digestive System Diagnoses Without Cc/Mcc","code_information":[{"code":"395","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6292.62,"maximum":24351.78,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22084.17},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6384.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14202.72},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":17180.33},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6323.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":13169.51},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19543.34},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":24351.78},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6568.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6292.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12525.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6507.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":13628.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6562.74,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inflammatory Bowel Disease Without Cc/Mcc","code_information":[{"code":"387","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6570.57,"maximum":25563.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23183.28},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6666.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14909.57},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":18035.37},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6602.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":13824.94},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20515.99},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":25563.74},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6859.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6570.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13078.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6794.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14230.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6852.62,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Gastrointestinal Hemorrhage Without Cc/Mcc","code_information":[{"code":"379","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6132.56,"maximum":23653.87,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21451.25},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6222.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13795.67},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":16687.95},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6162.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":12792.08},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18983.24},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":23653.87},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6401.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6132.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12207.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6341.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":13282.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6395.82,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Gastrointestinal Disorders And Peritoneal Infections With Mcc","code_information":[{"code":"371","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15965.78,"maximum":66530.26,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":60335.05},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16199.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":38802.52},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":46937.5},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16043.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":35979.75},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":53393.36},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":66530.26},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16666.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15965.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31780.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16510.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":34579.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16651.14,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Digestive System O.R. Procedures With Mcc","code_information":[{"code":"356","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":38508.94,"maximum":164826.64,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":149478.2},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39072.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":96132.04},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":116286.2},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38696.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":89138.7},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":132280.39},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":164826.64},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40199.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38508.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":76653.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39823.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":83404.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40162.01,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Anal And Stomal Procedures With Cc","code_information":[{"code":"348","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11970.36,"maximum":49108.79,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44535.85},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12145.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28641.78},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":34646.55},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12028.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":26558.17},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39411.89},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":49108.79},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12495.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11970.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23827.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12379.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":25926.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12484.21,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10873.88,"10th_percentile":10873.88,"90th_percentile":10873.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Rectal Resection Without Cc/Mcc","code_information":[{"code":"334","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14802.35,"maximum":61457.28,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55734.46},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15018.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35843.8},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":43358.49},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14874.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":33236.27},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":49322.08},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":61457.28},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15452.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14802.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29464.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15307.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":32059.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15437.77,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Stomach, Esophageal And Duodenal Procedures With Mcc","code_information":[{"code":"326","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":43625.63,"maximum":187137.22,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":169711.25},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44264.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":109144.26},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":132026.45},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43838.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":101204.32},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":150185.58},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":187137.22},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45540.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43625.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":86838.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45115.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":94486.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45498.34,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Percutaneous Coronary Atherectomy Without Intraluminal Device","code_information":[{"code":"318","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21551.44,"maximum":90885.79,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":82422.62},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21866.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":53007.42},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":64120.48},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21656.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":49151.28},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":72939.71},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":90885.79},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22497.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21551.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":42898.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22287.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":46677.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22476.58,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Arrhythmia And Conduction Disorders Without Cc/Mcc","code_information":[{"code":"310","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5579.25,"maximum":21241.2,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19263.25},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5660.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12388.53},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":14985.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5606.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":11487.3},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17046.97},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":21241.2},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5824.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5579.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11105.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5769.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":12083.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5818.75,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Atherosclerosis With Mcc","code_information":[{"code":"302","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11004.85,"maximum":44898.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40717.9},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11165.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26186.39},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":31676.4},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11058.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":24281.41},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36033.22},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":44898.83},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11487.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11004.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21905.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11380.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":23834.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11477.25,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Heart Failure And Shock With Cc","code_information":[{"code":"292","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8013.67,"maximum":31856.18,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28889.77},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8130.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18579.52},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":22474.73},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8052.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":17227.91},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25565.94},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":31856.18},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8365.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8013.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15951.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8287.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17356.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8357.67,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Myocardial Infarction, Expired With Cc","code_information":[{"code":"284","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6664.37,"maximum":25972.73,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23554.18},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6761.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15148.1},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":18323.92},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6696.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":14046.12},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20844.22},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":25972.73},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6956.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6664.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13265.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6891.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14434.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6950.45,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator","code_information":[{"code":"276","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":52396.09,"maximum":225379.65,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":204392.58},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53162.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":131448.43},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":159006.72},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52651.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":121885.93},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":180876.75},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":225379.65},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54696.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52396.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":104296.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54185.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":113482.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54645.29,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":46592.77,"10th_percentile":46592.77,"90th_percentile":46592.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc","code_information":[{"code":"268","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":59893.85,"maximum":258072.56,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":234041.18},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":60770.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":150515.96},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":182071.77},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":60186.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":139566.35},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":207114.2},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":258072.56},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":62523.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":59893.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":119220.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":61939.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":129721.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":62464.9,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Pacemaker Revision Except Device Replacement With Mcc","code_information":[{"code":"260","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":28698.96,"maximum":122051.56,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":110686.28},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29118.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":71184.28},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":86108.12},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28838.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":66005.82},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":97951.57},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":122051.56},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29958.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28698.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":57126.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29678.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":62157.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29930.92,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Vascular Procedures With Mcc","code_information":[{"code":"252","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":30725.5,"maximum":130887.99,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":118699.87},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31175.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":76337.96},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":92342.28},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30875.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":70784.58},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":105043.18},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":130887.99},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32074.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30725.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":61160.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31774.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":66546.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32044.45,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":63990.6,"10th_percentile":63990.6,"90th_percentile":63990.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":41587.98,"10th_percentile":41587.98,"90th_percentile":41587.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":28077.17,"10th_percentile":28077.17,"90th_percentile":28077.17},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":28077.17,"10th_percentile":28077.17,"90th_percentile":28077.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc","code_information":[{"code":"240","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":25237.07,"maximum":106956.46,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":96996.81},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25606.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":62380.34},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":75458.44},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25360.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":57842.35},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":85837.11},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":106956.46},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26345.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25237.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":50235.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26098.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":54659.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26320.42,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Cardiothoracic Procedures Without Mcc","code_information":[{"code":"229","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":27810.04,"maximum":118175.54,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":107171.19},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28217.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":68923.66},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":83373.56},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27945.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":63909.65},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":94840.89},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":118175.54},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29030.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27810.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":55356.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28759.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":60232.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29003.84,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Interstitial Lung Disease With Mcc","code_information":[{"code":"196","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16947.64,"maximum":70811.52,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":64217.64},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17195.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":41299.48},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":49957.96},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17030.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":38295.06},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":56829.25},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":70811.52},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17691.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16947.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":33734.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17526.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":36706.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17675.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pleural Effusion Without Cc/Mcc","code_information":[{"code":"188","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6879.49,"maximum":26910.78,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24404.88},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6980.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15695.2},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":18985.72},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6913.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":14553.42},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21597.04},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":26910.78},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7181.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6879.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13693.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7114.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14899.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7174.81,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Respiratory Neoplasms With Mcc","code_information":[{"code":"180","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15904.68,"maximum":66263.85,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":60093.45},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16137.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":38647.14},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":46749.55},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15982.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":35835.67},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":53179.56},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":66263.85},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16602.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15904.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31658.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16447.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":34447.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16587.42,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Respiratory System O.R. Procedures With Cc","code_information":[{"code":"167","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16226.52,"maximum":67667.17,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61366.1},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16463.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39465.61},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":47739.6},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16305.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":36594.59},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":54305.78},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":67667.17},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16938.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16226.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32299.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16780.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":35144.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16923.07,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Ear, Nose, Mouth And Throat Diagnoses Without Cc/Mcc","code_information":[{"code":"156","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6654.9,"maximum":25931.45,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23516.75},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6752.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15124.03},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":18294.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6687.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":14023.8},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20811.09},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":25931.45},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6947.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6654.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13246.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6882.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14413.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6940.58,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ear, Nose, Mouth And Throat Malignancy Without Cc/Mcc","code_information":[{"code":"148","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7567.05,"maximum":29908.79,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27123.72},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7677.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17443.74},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":21100.83},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7603.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":16174.75},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24003.07},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":29908.79},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7899.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7567.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15062.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7825.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16389.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7891.88,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Head And Neck Procedures With Mcc","code_information":[{"code":"140","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":37411.77,"maximum":160042.59,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":145139.63},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37959.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":93341.83},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":112911.02},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37594.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":86551.47},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":128440.98},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":160042.59},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39054.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37411.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":74469.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38689.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":81028.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39017.74,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Neurological Eye Disorders","code_information":[{"code":"123","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7579.97,"maximum":29965.07,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27174.76},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7690.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17476.56},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":21140.54},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7616.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":16205.19},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24048.24},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":29965.07},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7912.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7579.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15088.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7838.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16417.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7905.35,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Headaches Without Mcc","code_information":[{"code":"103","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7904.38,"maximum":31379.65,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28457.62},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8020.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18301.59},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":22138.53},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7942.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":16970.2},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25183.5},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":31379.65},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8251.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7904.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15733.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8174.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17119.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8243.69,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"1 through 10","median_amount":11883.82,"10th_percentile":11883.82,"90th_percentile":11883.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Bacterial And Tuberculous Infections Of Nervous System With Cc","code_information":[{"code":"095","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":22902.47,"maximum":96776.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":87765.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23237.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":56443.21},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":68276.58},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23014.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":52337.13},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":77667.45},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":96776.74},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23907.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22902.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":45588.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23684.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":49603.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23885.6,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Traumatic Stupor And Coma <1 Hour Without Cc/Mcc","code_information":[{"code":"087","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8579.03,"maximum":34321.37,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31125.41},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8704.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20017.29},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":24213.94},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8620.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":18561.09},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27544.36},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":34321.37},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8955.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8579.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17076.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8871.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":18580.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8947.31,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Viral Meningitis Without Cc/Mcc","code_information":[{"code":"076","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7808.86,"maximum":30963.15,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28079.91},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7923.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18058.68},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":21844.69},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7846.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":16744.96},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24849.25},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":30963.15},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8151.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7808.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15543.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8075.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16912.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8144.07,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Precerebral Occlusion Without Infarction Without Mcc","code_information":[{"code":"068","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8146.19,"maximum":32434.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29413.8},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8265.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18916.53},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":22882.4},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8185.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":17540.4},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26029.68},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":32434.02},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8503.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8146.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16215.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8424.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17643.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8495.88,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Multiple Sclerosis And Cerebellar Ataxia Without Cc/Mcc","code_information":[{"code":"060","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8622.93,"maximum":34512.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31298.95},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8749.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20128.9},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":24348.95},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8664.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":18664.58},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27697.94},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":34512.74},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9001.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8622.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17164.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8917.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":18675.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8993.08,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Spinal Disorders And Injuries With Cc/Mcc","code_information":[{"code":"052","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16294.5,"maximum":67963.6,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61634.92},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16532.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39638.49},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":47948.73},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16373.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":36754.9},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":54543.68},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":67963.6},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17009.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16294.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32434.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16850.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":35291.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16993.97,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Carotid Artery Stent Procedures With Cc","code_information":[{"code":"035","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21278.66,"maximum":89696.34,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":81343.93},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21590.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":52313.7},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":63281.32},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21382.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":48508.03},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":71985.13},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":89696.34},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22212.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21278.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":42355.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22005.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":46086.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22192.09,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc","code_information":[{"code":"027","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":22417.99,"maximum":94664.25,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":85849.24},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22746.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":55211.14},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":66786.21},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22527.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":51194.69},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":75972.09},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":94664.25},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23402.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22417.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":44623.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23183.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":48554.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23380.32,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Simultaneous Pancreas, Islet Cell And Kidney Transplant With Hemodialysis","code_information":[{"code":"019","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":62102.81,"maximum":267704.46,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":242776.17},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":63011.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":156133.59},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":188867.13},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":62405.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":144775.3},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":214844.21},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":267704.46},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":64829.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":62102.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":123617.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":64223.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":134505.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":64768.69,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pancreas Or Islet Cell Transplant","code_information":[{"code":"010","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":62456.49,"maximum":269246.62,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":244174.72},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":63370.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":157033.02},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":189955.13},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":62761.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":145609.3},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":216081.85},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":269246.62},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":65198.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":62456.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":124321.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":64589.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":135271.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":65137.55,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Heart Transplant Or Implant Of Heart Assist System With Mcc","code_information":[{"code":"001","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":241860.41,"maximum":1051512.78,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":953597.27},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":245399.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":613275.03},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":741848.68},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":243040.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":568660.98},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":843883.7},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":1051512.78},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":252478.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":241860.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":481432.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":250119.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":523834.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":252242.72,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Intraocular Procedures Without Cc/Mcc","code_information":[{"code":"117","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10043.65,"maximum":40707.62,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36916.98},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10190.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23741.95},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":28719.47},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10092.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":22014.79},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32669.59},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":40707.62},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10484.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10043.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19992.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10386.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":21753.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10474.79,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Mouth Procedures With Cc/Mcc","code_information":[{"code":"137","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13557.17,"maximum":56027.85,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50810.61},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13755.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32677.19},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":39527.99},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13623.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":30300.01},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":44964.73},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":56027.85},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14152.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13557.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26986.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14020.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29362.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14139.14,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Ear, Nose, Mouth And Throat O.R. Procedures Without Cc/Mcc","code_information":[{"code":"145","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11053.91,"maximum":45112.7,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40911.86},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11215.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26311.13},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":31827.29},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11107.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":24397.07},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36204.86},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":45112.7},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11539.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11053.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22003.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11431.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":23941.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11528.42,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Otitis Media And Uri Without Mcc","code_information":[{"code":"153","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7060.21,"maximum":27698.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25119.47},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7163.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16154.77},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":19541.63},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7094.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":14979.55},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22229.42},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":27698.74},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7370.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7060.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14053.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7301.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":15291.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7363.28,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":20006.48,"10th_percentile":20006.48,"90th_percentile":20006.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":3828.55,"10th_percentile":3828.55,"90th_percentile":3828.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Chest Procedures With Cc","code_information":[{"code":"164","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":22427.46,"maximum":94705.53,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":85886.67},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22755.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":55235.22},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":66815.33},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22536.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":51217.01},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":76005.21},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":94705.53},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23412.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22427.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":44642.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23193.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":48574.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23390.2,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"1 through 10","median_amount":240952.61,"10th_percentile":240952.61,"90th_percentile":240952.61},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Respiratory Infections And Inflammations With Mcc","code_information":[{"code":"177","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14155.23,"maximum":58635.63,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53175.56},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14362.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34198.13},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":41367.79},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14224.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":31710.31},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":47057.59},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":58635.63},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14776.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14155.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28176.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14638.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":30658.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14762.87,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12870.51,"10th_percentile":12870.51,"90th_percentile":12870.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":34198.13,"10th_percentile":34198.13,"90th_percentile":34198.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12058.79,"10th_percentile":12058.79,"90th_percentile":12058.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":2952.42,"10th_percentile":2952.42,"90th_percentile":2952.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":13002.99,"10th_percentile":13002.99,"90th_percentile":13002.99},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":11304.35,"10th_percentile":11304.35,"90th_percentile":11304.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Chest Trauma Without Cc/Mcc","code_information":[{"code":"185","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7475.84,"maximum":29511.05,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26763.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7585.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17211.77},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":20820.23},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7512.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":15959.66},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23683.87},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":29511.05},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7804.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7475.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14880.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7731.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16191.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7796.75,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Simple Pneumonia And Pleurisy With Mcc","code_information":[{"code":"193","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12018.56,"maximum":49318.92,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44726.4},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12194.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28764.33},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":34794.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12077.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":26671.8},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39580.53},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":49318.92},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12546.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12018.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23923.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12428.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":26030.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12534.47,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":3955.84,"10th_percentile":3955.84,"90th_percentile":3955.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11127.34,"10th_percentile":11127.34,"90th_percentile":11127.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":10449.37,"10th_percentile":10449.37,"90th_percentile":10661.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extensive O.R. Procedures Unrelated To Principal Diagnosis With Cc","code_information":[{"code":"982","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21863.81,"maximum":92247.84,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":83657.84},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22183.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":53801.81},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":65081.41},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21970.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":49887.88},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":74032.81},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":92247.84},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22823.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21863.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":43520.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22610.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":47353.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22802.36,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":18635.74,"10th_percentile":18635.74,"90th_percentile":18635.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Multiple Significant Trauma Without Cc/Mcc","code_information":[{"code":"965","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8801.05,"maximum":35289.44,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32003.33},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8929.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20581.9},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":24896.92},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8843.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":19084.63},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28321.28},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":35289.44},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9187.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8801.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17518.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9101.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":19061.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9178.85,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Factors Influencing Health Status","code_information":[{"code":"951","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5492.33,"maximum":20862.23,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18919.57},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5572.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12167.5},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":14718.43},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5519.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":11282.35},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16742.83},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":20862.23},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5733.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5492.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10932.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5679.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":11895.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5728.1,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"O.R. Procedures With Diagnoses Of Other Contact With Health Services With Cc","code_information":[{"code":"940","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":20817.42,"maximum":87685.16,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":79520.03},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21122.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":51140.72},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":61862.42},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20918.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":47420.37},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":70371.07},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":87685.16},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21731.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20817.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":41437.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21528.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":45087.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21711.05,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc","code_information":[{"code":"923","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9465.37,"maximum":38186.14,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34630.3},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9603.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22271.35},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":26940.55},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9511.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":20651.17},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30646.0},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":38186.14},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9880.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9465.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18841.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9788.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":20500.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9871.69,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Allergic Reactions With Mcc","code_information":[{"code":"915","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15178.39,"maximum":63097.0,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57221.48},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15400.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36800.13},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":44515.32},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15252.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":34123.03},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":50638.02},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":63097.0},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15844.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15178.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30213.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15696.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":32874.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15829.96,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Grafts For Injuries With Cc/Mcc","code_information":[{"code":"904","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":32315.75,"maximum":137822.06,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":124988.25},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32788.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":80382.12},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":97234.3},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32473.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":74534.55},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":110608.06},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":137822.06},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33734.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32315.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":64325.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33419.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":69991.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33702.96,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"O.R. Procedures With Principal Diagnosis Of Mental Illness","code_information":[{"code":"876","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":33966.23,"maximum":145018.78,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":131514.82},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34463.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":84579.47},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":102311.63},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34131.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":78426.55},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":116383.73},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":145018.78},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35457.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33966.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":67611.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35126.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":73565.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35424.3,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Viral Illness With Mcc","code_information":[{"code":"865","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13601.05,"maximum":56219.21,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50984.15},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13800.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32788.8},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":39663.0},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13667.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":30403.5},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45118.31},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":56219.21},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14198.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13601.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27073.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14065.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29457.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14184.9,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Infectious And Parasitic Diseases With O.R. Procedures With Cc","code_information":[{"code":"854","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17901.96,"maximum":74972.71,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":67991.35},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18163.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":43726.42},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":52893.7},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17989.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":40545.45},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":60168.79},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":74972.71},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18687.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17901.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":35634.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18513.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":38773.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18670.44,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16230.13,"10th_percentile":16230.13,"90th_percentile":16230.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":16417.62,"10th_percentile":16417.62,"90th_percentile":16417.62},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses With Cc","code_information":[{"code":"844","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11183.85,"maximum":45679.28,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41425.69},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11347.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26641.58},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":32227.01},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11238.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":24703.48},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36659.57},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":45679.28},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11674.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11183.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22261.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11565.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":24222.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11663.93,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Leukemia Without Cc/Mcc","code_information":[{"code":"836","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11201.92,"maximum":45758.08,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41497.15},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11365.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26687.54},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":32282.6},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11256.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":24746.09},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36722.8},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":45758.08},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11693.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11201.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22297.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11584.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":24261.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11682.78,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.R. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lymphoma And Leukemia With Major O.R. Procedures With Mcc","code_information":[{"code":"820","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":51175.87,"maximum":220059.03,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":199567.41},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51924.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":128345.28},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":155252.99},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51425.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":119008.52},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":176606.72},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":220059.03},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53422.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51175.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":101867.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52923.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":110839.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53372.69,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Red Blood Cell Disorders Without Mcc","code_information":[{"code":"812","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8609.15,"maximum":34452.7,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31244.51},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8735.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20093.89},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":24306.59},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8651.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":18632.11},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27649.76},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":34452.7},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8987.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8609.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17136.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8903.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":18646.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8978.71,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19883.01,"10th_percentile":19883.01,"90th_percentile":19883.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":15115.32,"10th_percentile":15115.32,"90th_percentile":15115.32},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":7923.41,"10th_percentile":7923.41,"90th_percentile":7923.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other O.R. Procedures Of The Blood And Blood Forming Organs Without Cc/Mcc","code_information":[{"code":"804","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12376.53,"maximum":50879.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46141.97},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12557.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29674.7},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":35896.03},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12436.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":27515.95},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40833.23},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":50879.83},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12919.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12376.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24635.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12799.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":26805.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12907.81,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/Mcc","code_information":[{"code":"373","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6967.27,"maximum":27293.5,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24751.97},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7069.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15918.42},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":19255.73},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7001.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":14760.4},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21904.2},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":27293.5},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7273.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6967.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13868.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7205.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":15090.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7266.36,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Complicated Peptic Ulcer With Cc","code_information":[{"code":"381","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10031.6,"maximum":40655.09,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36869.34},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10178.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23711.31},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":28682.41},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10080.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":21986.38},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32627.44},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":40655.09},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10472.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10031.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19968.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10374.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":21726.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10462.23,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Gastrointestinal Obstruction With Cc","code_information":[{"code":"389","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7504.24,"maximum":29634.88,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26875.31},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7614.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17283.98},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":20907.59},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7540.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":16026.62},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23783.25},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":29634.88},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7833.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7504.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14937.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7760.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16253.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7826.37,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":19160.71,"10th_percentile":19160.71,"90th_percentile":19160.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":6116.28,"10th_percentile":6116.28,"90th_percentile":6914.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Appendix Procedures With Cc","code_information":[{"code":"398","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13732.71,"maximum":56793.3,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51504.78},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13933.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33123.62},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":40068.02},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13799.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":30713.97},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45579.04},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":56793.3},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14335.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13732.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27335.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14201.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29743.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14322.22,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.D.E. Without Cc/Mcc","code_information":[{"code":"410","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14370.37,"maximum":59573.68,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":54026.26},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14580.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34745.23},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":42029.59},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14440.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":32217.61},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":47810.41},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":59573.68},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15001.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14370.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28604.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14861.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":31124.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14987.24,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Laparoscopic Cholecystectomy Without C.D.E. With Cc","code_information":[{"code":"418","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15264.45,"maximum":63472.22,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57561.76},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15487.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":37018.97},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":44780.04},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15338.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":34325.95},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":50939.15},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":63472.22},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15934.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15264.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30384.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15785.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":33060.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15919.71,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"1 through 10","median_amount":24037.64,"10th_percentile":24037.64,"90th_percentile":24037.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":41128.34,"10th_percentile":41128.34,"90th_percentile":41128.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignancy Of Hepatobiliary System Or Pancreas With Mcc","code_information":[{"code":"435","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16513.07,"maximum":68916.66,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62499.23},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16754.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40194.34},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":48621.12},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16593.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":37270.32},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":55308.55},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":68916.66},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17238.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16513.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32869.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17076.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":35764.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17221.92,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"1 through 10","median_amount":26099.51,"10th_percentile":26099.51,"90th_percentile":26099.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis Without Cc/Mcc","code_information":[{"code":"443","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6728.91,"maximum":26254.14,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23809.39},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6827.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15312.23},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":18522.46},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6761.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":14198.31},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21070.07},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":26254.14},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7024.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6728.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13394.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6958.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14573.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7017.76,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Or Infection With Mcc","code_information":[{"code":"456","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":73021.15,"maximum":315312.37,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":285950.9},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":74089.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":183900.01},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":222454.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":73377.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":170521.79},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":253051.58},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":315312.37},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":76226.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":73021.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":145351.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":75514.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":158153.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":76155.72,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Revision Of Hip Or Knee Replacement With Mcc","code_information":[{"code":"466","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":45501.57,"maximum":195317.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":177129.35},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46167.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":113914.97},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":137797.35},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45723.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":105627.98},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":156750.21},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":195317.02},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47499.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45501.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":90572.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47055.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":98549.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47454.81,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc Or Insertion Of Antib","code_information":[{"code":"474","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":37649.29,"maximum":161078.19,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":146078.8},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38200.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":93945.82},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":113641.65},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37832.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":87111.53},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":129272.1},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":161078.19},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39302.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37649.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":74942.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38934.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":81542.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39265.45,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hip And Femur Procedures Except Major Joint Without Cc/Mcc","code_information":[{"code":"482","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14742.97,"maximum":61198.38,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55499.67},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14958.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35692.8},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":43175.83},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14814.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":33096.25},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":49114.3},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":61198.38},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15390.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14742.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29346.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15246.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":31931.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15375.84,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13023.94,"10th_percentile":13023.94,"90th_percentile":13023.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc","code_information":[{"code":"493","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":22531.58,"maximum":95159.54,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":86298.41},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22861.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":55500.01},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":67135.64},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22641.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":51462.54},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":76369.58},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":95159.54},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23520.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22531.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":44849.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23300.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":48800.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23498.79,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Soft Tissue Procedures With Cc","code_information":[{"code":"501","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15750.65,"maximum":65592.21,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59484.35},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15981.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":38255.42},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":46275.7},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15827.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":35472.45},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":52640.54},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":65592.21},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16442.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15750.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31352.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16288.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":34113.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16426.78,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14287.48,"10th_percentile":14287.48,"90th_percentile":14287.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc","code_information":[{"code":"510","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":26699.97,"maximum":113335.2,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":102781.57},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27090.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":66100.62},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":79958.68},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26830.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":61291.99},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":90956.32},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":113335.2},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27872.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26699.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":53147.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27611.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":57828.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27846.11,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurostimulator","code_information":[{"code":"518","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":32868.2,"maximum":140230.97,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":127172.84},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33349.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":81787.07},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":98933.81},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33028.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":75837.29},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":112541.31},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":140230.97},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34311.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32868.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":65425.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33990.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":71187.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34279.13,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Fractures Of Hip And Pelvis Without Mcc","code_information":[{"code":"536","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7657.42,"maximum":30302.77,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27481.01},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7769.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17673.52},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":21378.79},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7694.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":16387.82},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24319.26},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":30302.77},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7993.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7657.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15242.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7918.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16584.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7986.12,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy Without Cc/Mcc","code_information":[{"code":"544","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7201.33,"maximum":28314.1,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25677.53},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7306.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16513.67},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":19975.77},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7236.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":15312.34},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22723.27},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":28314.1},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7517.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7201.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14334.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7447.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":15597.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7510.46,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Medical Back Problems Without Mcc","code_information":[{"code":"552","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8980.04,"maximum":36069.9,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32711.12},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9111.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21037.09},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":25447.53},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9023.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":19506.7},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28947.63},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":36069.9},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9374.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8980.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17875.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9286.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":19449.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9365.52,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":25575.11,"10th_percentile":25575.11,"90th_percentile":25575.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8340.64,"10th_percentile":8340.64,"90th_percentile":8340.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Aftercare, Musculoskeletal System And Connective Tissue With Cc","code_information":[{"code":"560","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10398.18,"maximum":42253.52,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38318.93},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10550.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24643.57},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":29810.12},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10448.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":22850.82},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33910.25},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":42253.52},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10854.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10398.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20697.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10753.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":22520.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10844.55,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Debridement With Cc","code_information":[{"code":"571","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15246.38,"maximum":63393.42,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57490.31},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15469.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36973.02},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":44724.44},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15320.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":34283.33},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":50875.91},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":63393.42},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15915.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15246.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30348.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15766.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":33021.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15900.86,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":1983.56,"10th_percentile":1983.56,"90th_percentile":1983.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc","code_information":[{"code":"579","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":28575.91,"maximum":121515.0,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":110199.68},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28994.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":70871.33},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":85729.57},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28715.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":65715.64},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":97520.95},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":121515.0},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29830.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28575.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":56881.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29551.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":61891.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29802.59,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Ulcers With Cc","code_information":[{"code":"593","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10916.22,"maximum":44512.35,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40367.42},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11075.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25960.99},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":31403.73},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10969.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":24072.4},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35723.05},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":44512.35},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11395.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10916.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21729.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11288.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":23642.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11384.82,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Non-Malignant Breast Disorders Without Cc/Mcc","code_information":[{"code":"601","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5913.99,"maximum":22700.81,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20586.94},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6000.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13239.82},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":16015.56},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5942.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":12276.66},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18218.37},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":22700.81},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6173.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5913.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11772.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6115.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":12808.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6167.86,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Adrenal And Pituitary Procedures Without Cc/Mcc","code_information":[{"code":"615","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12749.13,"maximum":52504.53,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47615.38},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12935.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30622.28},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":37042.27},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12811.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":28394.6},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42137.12},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":52504.53},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13308.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12749.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25377.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13184.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":27612.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13296.41,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disorders With Cc","code_information":[{"code":"623","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16144.76,"maximum":67310.72,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61042.83},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16381.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39257.71},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":47488.12},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16223.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":36401.82},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":54019.71},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":67310.72},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16853.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16144.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32136.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16696.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":34967.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16837.81,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Diabetes With Mcc","code_information":[{"code":"637","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13070.97,"maximum":53907.86,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48888.03},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13262.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31440.74},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":38032.32},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13134.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":29153.52},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":43263.35},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":53907.86},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13644.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13070.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26018.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13517.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":28309.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13632.07,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":10212.94,"10th_percentile":7832.04,"90th_percentile":10315.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Endocrine Disorders Without Cc/Mcc","code_information":[{"code":"645","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7319.23,"maximum":28828.15,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26143.71},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7426.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16813.48},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":20338.44},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7354.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":15590.34},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23135.82},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":28828.15},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7640.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7319.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14569.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7569.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":15852.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7633.42,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Ureter Procedures For Neoplasm With Cc","code_information":[{"code":"657","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16455.42,"maximum":68665.26,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62271.24},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16696.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40047.72},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":48443.76},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16535.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":37134.36},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":55106.79},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":68665.26},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17177.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16455.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32755.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17017.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":35640.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17161.8,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Prostatectomy With Mcc","code_information":[{"code":"665","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":27566.51,"maximum":117113.67,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":106208.19},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27969.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":68304.34},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":82624.41},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27700.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":63335.39},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":93988.7},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":117113.67},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28776.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27566.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":54872.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28507.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":59705.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28749.86,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Kidney And Urinary Tract Procedures With Mcc","code_information":[{"code":"673","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":36863.62,"maximum":157652.44,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":142972.04},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37403.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":91947.81},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":111224.76},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37043.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":85258.87},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":126522.78},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":157652.44},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38482.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36863.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":73378.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38122.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":79841.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38446.06,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Urinary Tract Neoplasms Without Cc/Mcc","code_information":[{"code":"688","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7508.55,"maximum":29653.64,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26892.33},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7618.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17294.93},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":20920.82},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7545.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":16036.77},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23798.3},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":29653.64},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7838.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7508.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14946.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7764.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16262.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7830.86,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Kidney And Urinary Tract Diagnoses With Mcc","code_information":[{"code":"698","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14944.34,"maximum":62076.4,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56295.92},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15163.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36204.89},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":43795.28},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15017.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":33571.08},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":49818.95},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":62076.4},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15600.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14944.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29747.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15454.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":32367.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15585.85,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13559.39,"10th_percentile":13559.39,"90th_percentile":13559.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14137.23,"10th_percentile":14137.23,"90th_percentile":14137.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":34313.3,"10th_percentile":34313.3,"90th_percentile":34313.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":13706.57,"10th_percentile":13706.57,"90th_percentile":13706.57},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Testes Procedures Without Cc/Mcc","code_information":[{"code":"712","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10171.0,"maximum":41262.94,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37420.59},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10319.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24065.83},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":29111.26},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10220.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":22315.11},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33115.27},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":41262.94},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10617.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10171.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20245.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10518.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":22028.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10607.61,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignancy, Male Reproductive System With Cc","code_information":[{"code":"723","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10541.03,"maximum":42876.39,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38883.8},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10695.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25006.85},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":30249.55},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10592.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":23187.67},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34410.13},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":42876.39},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11003.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10541.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20982.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10900.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":22830.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10993.52,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/Mcc","code_information":[{"code":"734","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19036.99,"maximum":79921.86,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":72479.64},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19315.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46612.92},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":56385.36},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19129.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":43221.96},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":64140.69},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":79921.86},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19872.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19036.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37893.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19687.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":41231.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19854.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Uterine And Adnexa Procedures For Non-Malignancy With Cc/Mcc","code_information":[{"code":"742","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16496.72,"maximum":68845.37,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62434.57},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16738.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40152.76},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":48570.83},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16577.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":37231.76},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":55251.33},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":68845.37},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17220.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16496.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32837.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17060.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":35729.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17204.87,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":5452.62,"10th_percentile":5452.62,"90th_percentile":5452.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Esophageal Disorders With Mcc","code_information":[{"code":"368","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14406.51,"maximum":59731.27,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":54169.17},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14617.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34837.14},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":42140.78},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14476.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":32302.83},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":47936.88},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":59731.27},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15038.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14406.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28676.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14898.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":31202.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15024.93,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12160.58,"10th_percentile":12160.58,"90th_percentile":12160.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hernia Procedures Except Inguinal And Femoral With Mcc","code_information":[{"code":"353","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":25680.25,"maximum":108888.84,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":98749.26},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26056.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":63507.37},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":76821.74},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25805.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":58887.38},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":87387.93},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":108888.84},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26807.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25680.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":51117.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26557.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":55619.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26782.62,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Minor Small And Large Bowel Procedures With Cc","code_information":[{"code":"345","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13656.13,"maximum":56459.35,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51201.93},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13855.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32928.85},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":39832.42},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13722.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":30533.37},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45311.03},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":56459.35},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14255.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13656.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27183.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14122.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29577.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14242.34,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Small And Large Bowel Procedures Without Cc/Mcc","code_information":[{"code":"331","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15189.59,"maximum":63145.77,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57265.72},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15411.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36828.58},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":44549.73},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15263.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":34149.41},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":50677.17},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":63145.77},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15856.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15189.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30235.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15708.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":32898.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15841.63,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc","code_information":[{"code":"323","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":37946.17,"maximum":162372.7,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":147252.77},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38501.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":94700.82},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":114554.93},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38131.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":87811.6},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":130311.0},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":162372.7},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39612.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37946.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":75533.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39241.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":82185.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39575.07,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":33008.84,"10th_percentile":33008.84,"90th_percentile":33008.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Circulatory System Diagnoses With Cc","code_information":[{"code":"315","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8997.24,"maximum":36144.94,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32779.17},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9128.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21080.86},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":25500.48},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9041.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":19547.28},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29007.85},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":36144.94},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9392.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8997.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17909.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9304.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":19486.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9383.47,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Congenital And Valvular Disorders Without Mcc","code_information":[{"code":"307","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8566.13,"maximum":34265.09,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31074.37},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8691.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19984.47},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":24174.23},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8607.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":18530.65},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27499.19},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":34265.09},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8942.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8566.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17051.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8858.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":18552.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8933.85,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Peripheral Vascular Disorders With Mcc","code_information":[{"code":"299","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14757.6,"maximum":61262.17,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55557.52},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14973.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35730.01},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":43220.83},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14829.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":33130.75},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":49165.5},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":61262.17},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15405.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14757.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29375.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15261.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":31962.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15391.1,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute And Subacute Endocarditis With Cc","code_information":[{"code":"289","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15396.12,"maximum":64046.3,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":58082.39},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15621.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":37353.8},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":45185.06},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15471.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":34636.41},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":51399.88},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":64046.3},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16072.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15396.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30646.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15921.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":33345.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16057.02,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Myocardial Infarction, Discharged Alive With Cc","code_information":[{"code":"281","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8616.9,"maximum":34486.47,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31275.13},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8743.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20113.58},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":24330.42},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8658.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":18650.38},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27676.86},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":34486.47},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8995.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8616.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17152.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8911.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":18662.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8986.79,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":27676.86,"10th_percentile":27676.86,"90th_percentile":27676.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8235.08,"10th_percentile":8235.08,"90th_percentile":8235.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19432.13,"10th_percentile":19432.13,"90th_percentile":19432.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":7947.95,"10th_percentile":7947.95,"90th_percentile":7947.95},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":6269.84,"10th_percentile":6255.14,"90th_percentile":6980.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Percutaneous And Other Intracardiac Procedures With Mcc","code_information":[{"code":"273","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":36208.76,"maximum":154797.01,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":140382.51},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36738.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":90282.44},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":109210.24},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36385.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":83714.65},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":124231.18},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":154797.01},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37798.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36208.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":72074.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37445.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":78422.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37763.09,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":39176.33,"10th_percentile":39176.33,"90th_percentile":39176.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":32973.32,"10th_percentile":32973.32,"90th_percentile":32973.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Aicd Lead Procedures","code_information":[{"code":"265","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":31843.32,"maximum":135762.1,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":123120.11},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32309.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":79180.69},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":95780.99},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31998.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":73420.51},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":108954.86},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":135762.1},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33241.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31843.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":63385.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32930.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":68967.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33210.25,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Upper Limb And Toe Amputation For Circulatory System Disorders Without Cc/Mcc","code_information":[{"code":"257","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10106.47,"maximum":40981.53,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37165.38},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10254.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23901.7},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":28912.72},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10155.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":22162.92},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32889.42},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":40981.53},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10550.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10106.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20117.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10451.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":21889.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10540.31,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Coronary Bypass Without Cardiac Catheterization With Mcc","code_information":[{"code":"235","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":51208.57,"maximum":220201.61,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":199696.72},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51957.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":128428.44},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":155353.58},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51458.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":119085.63},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":176721.15},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":220201.61},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53456.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51208.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":101932.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52957.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":110910.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53406.79,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheterization With Cc","code_information":[{"code":"220","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":46597.88,"maximum":200097.32,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":181464.52},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47279.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":116703.0},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":141169.88},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46825.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":108213.18},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":160586.61},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":200097.32},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48643.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46597.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":92754.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48189.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":100924.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48598.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Complex Aortic Arch Procedures","code_information":[{"code":"209","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":98108.89,"maximum":424704.01,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":385156.13},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":99544.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":247700.62},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":299631.27},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":98587.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":229681.09},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":340843.02},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":424704.01},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":102416.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":98108.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":195289.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":101458.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":212489.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":102320.39,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pneumothorax Without Cc/Mcc","code_information":[{"code":"201","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6861.42,"maximum":26831.98,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24333.42},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6961.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15649.25},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":18930.13},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6894.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":14510.81},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21533.81},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":26831.98},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7162.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6861.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13657.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7095.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14860.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7155.96,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Digestive Malignancy Without Cc/Mcc","code_information":[{"code":"376","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8661.64,"maximum":34681.58,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31452.08},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8788.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20227.38},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":24468.07},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8703.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":18755.9},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27833.45},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":34681.58},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9041.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8661.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17241.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8957.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":18759.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9033.46,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Uncomplicated Peptic Ulcer Without Mcc","code_information":[{"code":"384","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8063.58,"maximum":32073.81,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29087.13},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8181.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18706.44},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":22628.27},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8102.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":17345.6},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25740.59},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":32073.81},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8417.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8063.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16050.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8338.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17464.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8409.73,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc","code_information":[{"code":"392","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7416.47,"maximum":29252.15,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26528.23},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7525.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17060.77},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":20637.57},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7452.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":15819.64},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23476.09},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":29252.15},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7742.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7416.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14762.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7669.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16062.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7734.84,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"1 through 10","median_amount":25265.28,"10th_percentile":25265.28,"90th_percentile":25265.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":22918.99,"10th_percentile":22918.99,"90th_percentile":22918.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6210.45,"10th_percentile":6210.45,"90th_percentile":6210.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":69941.98,"10th_percentile":69941.98,"90th_percentile":69941.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":3421.23,"10th_percentile":3421.23,"90th_percentile":3421.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":5002.03,"10th_percentile":5002.03,"90th_percentile":5278.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pancreas, Liver And Shunt Procedures With Mcc","code_information":[{"code":"405","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":47782.82,"maximum":205264.1,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":186150.17},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48482.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":119716.42},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":144815.08},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48015.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":111007.39},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":164733.17},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":205264.1},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49880.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47782.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":95113.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49414.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":103490.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49833.99,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cholecystectomy With C.D.E. Without Cc/Mcc","code_information":[{"code":"413","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14996.83,"maximum":62305.28,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56503.49},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15216.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36338.38},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":43956.76},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15069.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":33694.87},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":50002.64},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":62305.28},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15655.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14996.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29851.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15508.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":32480.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15640.59,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hepatobiliary Diagnostic Procedures With Cc","code_information":[{"code":"421","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15659.43,"maximum":65194.48,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59123.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15888.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":38023.45},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":45995.1},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15735.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":35257.35},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":52321.34},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":65194.48},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16346.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15659.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31170.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16194.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":33916.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16331.64,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Combined Anterior And Posterior Cervical Spinal Fusion With Mcc","code_information":[{"code":"429","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":78237.66,"maximum":338058.21,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":306578.67},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":79382.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":197166.09},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":238502.13},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":78619.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":182822.8},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":271306.08},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":338058.21},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":81672.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":78237.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":155734.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":80909.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":169451.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":81596.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Disorders Of Pancreas Except Malignancy With Mcc","code_information":[{"code":"438","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14736.09,"maximum":61168.36,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55472.45},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14951.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35675.3},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":43154.65},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14807.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":33080.02},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":49090.21},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":61168.36},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15383.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14736.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29332.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15239.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":31916.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15368.66,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":33152.53,"10th_percentile":33152.53,"90th_percentile":33152.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Disorders Of The Biliary Tract Without Cc/Mcc","code_information":[{"code":"446","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7826.93,"maximum":31041.95,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28151.36},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7941.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18104.63},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":21900.29},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7865.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":16787.57},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24912.48},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":31041.95},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8170.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7826.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15579.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8094.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16951.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8162.92,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc","code_information":[{"code":"461","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":48234.59,"maximum":207234.01,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":187936.64},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48940.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":120865.33},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":146204.86},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48469.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":112072.72},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":166314.1},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":207234.01},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50352.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48234.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":96012.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49881.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":104469.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50305.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc Or Total Ankle Repl","code_information":[{"code":"469","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":26809.25,"maximum":113811.73,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":103213.73},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27201.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":66378.55},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":80294.87},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26940.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":61549.69},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":91338.75},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":113811.73},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27986.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26809.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":53364.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27724.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":58064.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27960.09,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Biopsies Of Musculoskeletal System And Connective Tissue With Mcc Or Insertion Of Antibiotic-Eluting","code_information":[{"code":"477","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":30435.5,"maximum":129623.5,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":117553.13},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30880.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":75600.47},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":91450.17},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30583.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":70100.74},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":104028.37},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":129623.5},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31771.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30435.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":60582.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31474.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":65918.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31742.0,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Knee Procedures With Principal Diagnosis Of Infection With Cc","code_information":[{"code":"486","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18702.25,"maximum":78462.25,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":71155.95},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18975.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45761.63},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":55355.6},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18793.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":42432.6},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":62969.29},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":78462.25},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19523.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18702.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37227.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19340.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":40506.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19505.08,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur With Cc","code_information":[{"code":"496","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16230.82,"maximum":67685.94,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61383.11},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16468.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39476.55},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":47752.84},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16310.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":36604.74},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":54320.84},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":67685.94},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16943.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16230.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32308.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16785.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":35153.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16927.56,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Foot Procedures With Cc","code_information":[{"code":"504","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16792.74,"maximum":70136.12,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":63605.14},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17038.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40905.57},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":49481.46},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16874.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":37929.81},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":56287.22},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":70136.12},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17529.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16792.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":33426.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17366.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":36370.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17513.6,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures With Cc/Mcc","code_information":[{"code":"513","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14255.05,"maximum":59070.88,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53570.28},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14463.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34451.98},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":41674.87},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14324.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":31945.7},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":47406.9},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":59070.88},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14880.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14255.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28375.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14741.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":30874.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14866.98,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc","code_information":[{"code":"521","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":25406.59,"maximum":107695.64,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":97667.17},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25778.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":62811.46},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":75979.93},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25530.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":58242.1},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":86430.33},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":107695.64},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26522.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25406.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":50572.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26274.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":55026.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26497.22,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23035.81,"10th_percentile":23035.81,"90th_percentile":23035.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Osteomyelitis With Mcc","code_information":[{"code":"539","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17657.57,"maximum":73907.08,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":67024.95},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17915.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":43104.91},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":52141.9},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17743.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":39969.15},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":59313.58},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":73907.08},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18432.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17657.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":35148.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18260.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":38243.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18415.56,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17782.62,"10th_percentile":17782.62,"90th_percentile":17782.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":32596.77,"10th_percentile":32596.77,"90th_percentile":32596.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses With Mcc","code_information":[{"code":"843","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17873.56,"maximum":74848.89,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":67879.05},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18135.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":43654.2},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":52806.35},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17960.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":40478.48},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":60069.41},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":74848.89},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18658.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17873.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":35577.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18483.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":38711.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18640.82,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Infectious And Parasitic Diseases With O.R. Procedures With Mcc","code_information":[{"code":"853","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":43205.69,"maximum":185306.15,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":168050.68},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43837.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":108076.32},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":130734.62},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43416.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":100214.07},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":148716.06},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":185306.15},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45102.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43205.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":86002.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44681.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":93577.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45060.37,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":108076.32,"10th_percentile":108076.32,"90th_percentile":127526.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":38550.37,"10th_percentile":38550.37,"90th_percentile":40800.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":97301.82,"10th_percentile":97301.82,"90th_percentile":97301.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":24790.69,"10th_percentile":24790.69,"90th_percentile":24790.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":54757.15,"10th_percentile":54757.15,"90th_percentile":54757.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Fever And Inflammatory Conditions","code_information":[{"code":"864","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8346.69,"maximum":33308.28,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30206.66},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8468.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19426.43},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":23499.19},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8387.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":18013.21},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26731.31},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":33308.28},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8713.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8346.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16614.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8631.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":18077.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8704.98,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Connective Tissue Disorders Without Cc/Mcc","code_information":[{"code":"547","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7903.52,"maximum":31375.9,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28454.21},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8019.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18299.4},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":22135.89},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7942.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":16968.17},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25180.49},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":31375.9},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8250.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7903.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15732.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8173.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17117.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8242.79,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":3279.32,"10th_percentile":3279.32,"90th_percentile":3279.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Signs And Symptoms Of Musculoskeletal System And Connective Tissue With Mcc","code_information":[{"code":"555","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12082.23,"maximum":49596.58,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44978.21},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12259.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28926.27},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":34990.69},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12141.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":26821.97},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39803.36},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":49596.58},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12612.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12082.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24050.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12494.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":26168.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12600.88,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Without Mcc","code_information":[{"code":"563","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8413.82,"maximum":33600.95,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30472.07},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8536.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19597.12},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":23705.68},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8454.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":18171.49},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26966.19},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":33600.95},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8783.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8413.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16748.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8701.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":18223.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8774.99,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":6504.61,"10th_percentile":6504.61,"90th_percentile":6504.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":6084.7,"10th_percentile":6084.7,"90th_percentile":6084.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Graft For Skin Ulcer Or Cellulitis With Cc","code_information":[{"code":"574","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":30580.08,"maximum":130253.87,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":118124.8},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31027.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":75968.12},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":91894.9},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30729.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":70441.65},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":104534.27},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":130253.87},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31922.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30580.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":60870.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31624.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":66231.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31892.78,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Mastectomy For Malignancy With Cc/Mcc","code_information":[{"code":"582","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17286.69,"maximum":72289.89,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":65558.34},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17539.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42161.71},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":51000.96},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17371.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":39094.57},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":58015.71},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":72289.89},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18045.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17286.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34409.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17876.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":37440.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18028.75,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Skin Disorders Without Mcc","code_information":[{"code":"596","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10022.99,"maximum":40617.57,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36835.31},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10169.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23689.43},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":28655.94},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10071.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":21966.09},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32597.32},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":40617.57},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10463.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10022.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19951.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10365.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":21708.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10453.25,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc","code_information":[{"code":"604","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13375.59,"maximum":55236.14,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50092.62},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13571.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32215.44},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":38969.43},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13440.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":29871.85},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":44329.35},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":55236.14},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13962.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13375.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26624.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13832.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":28969.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13949.77,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders Without Cc/Mcc","code_information":[{"code":"618","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12912.63,"maximum":53217.45,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48261.91},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13101.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31038.08},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":37545.24},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12975.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":28780.14},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42709.27},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":53217.45},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13479.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12912.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25703.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13353.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":27966.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13466.93,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Thyroid, Parathyroid And Thyroglossal Procedures With Cc","code_information":[{"code":"626","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13610.52,"maximum":56260.49,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51021.58},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13809.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32812.87},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":39692.12},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13676.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":30425.82},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45151.43},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":56260.49},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14208.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13610.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27092.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14075.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29478.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14194.78,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With Mcc","code_information":[{"code":"640","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12200.98,"maximum":50114.38,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45447.8},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12379.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29228.27},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":35356.0},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12260.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":27102.0},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40218.92},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":50114.38},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12736.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12200.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24286.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12617.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":26425.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12724.73,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":40218.92,"10th_percentile":40218.92,"90th_percentile":40218.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11338.68,"10th_percentile":11338.68,"90th_percentile":11338.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"1 through 10","median_amount":11217.22,"10th_percentile":11217.22,"90th_percentile":11217.22},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":9640.3,"10th_percentile":9640.3,"90th_percentile":9640.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney Transplant","code_information":[{"code":"652","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":28498.46,"maximum":121177.3,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":109893.43},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28915.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":70674.38},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":85491.32},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28637.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":65533.01},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":97249.93},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":121177.3},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29749.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28498.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":56727.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29471.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":61723.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29721.81,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Ureter Procedures For Non-Neoplasm With Cc","code_information":[{"code":"660","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12081.37,"maximum":49592.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44974.81},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12258.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28924.08},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":34988.04},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12140.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":26819.94},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39800.35},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":49592.83},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12611.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12081.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24048.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12493.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":26166.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12599.98,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":40019.67,"10th_percentile":40019.67,"90th_percentile":40019.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":26833.72,"10th_percentile":26833.72,"90th_percentile":26833.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Transurethral Procedures With Mcc","code_information":[{"code":"668","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":25835.14,"maximum":109564.24,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":99361.76},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26213.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":63901.28},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":77298.24},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25961.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":59252.64},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":87929.96},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":109564.24},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26969.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25835.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":51425.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26717.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":55955.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26944.16,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Renal Failure With Mcc","code_information":[{"code":"682","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13452.18,"maximum":55570.08,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50395.47},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13649.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32410.2},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":39205.03},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13517.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":30052.45},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":44597.35},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":55570.08},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14042.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13452.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26777.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13911.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29135.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14029.64,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11414.7,"10th_percentile":11408.7,"90th_percentile":12215.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":30556.81,"10th_percentile":30556.81,"90th_percentile":30556.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Urinary Stones With Mcc","code_information":[{"code":"693","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12277.57,"maximum":50448.33,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45750.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12457.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29423.04},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":35591.6},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12337.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":27282.59},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40486.93},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":50448.33},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12816.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12277.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24438.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12696.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":26591.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12804.61,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Male Reproductive System And Other O.R. Procedures For Malignancy With Cc/Mcc","code_information":[{"code":"715","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19960.34,"maximum":83947.97,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":76130.84},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20252.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":48961.07},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":59225.81},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20057.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":45399.29},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":67371.81},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":83947.97},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20836.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19960.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":39731.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20641.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":43231.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20817.17,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Benign Prostatic Hypertrophy Without Mcc","code_information":[{"code":"726","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6920.8,"maximum":27090.88,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24568.22},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7022.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15800.25},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":19112.78},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6954.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":14650.82},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21741.59},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":27090.88},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7224.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6920.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13776.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7157.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14989.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7217.89,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc","code_information":[{"code":"737","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18439.79,"maximum":77317.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":70118.1},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18709.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45094.17},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":54548.2},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18529.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":41813.7},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":62050.85},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":77317.83},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19249.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18439.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":36705.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19069.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":39937.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19231.35,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"D&C, Conization, Laparoscopy And Tubal Interruption Without Cc/Mcc","code_information":[{"code":"745","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10496.29,"maximum":42681.28,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38706.85},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10649.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24893.05},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":30111.9},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10547.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":23082.15},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34253.54},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":42681.28},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10957.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10496.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20893.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10854.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":22733.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10946.86,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignancy, Female Reproductive System Without Cc/Mcc","code_information":[{"code":"756","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8973.16,"maximum":36039.88,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32683.89},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9104.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21019.58},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":25426.36},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9016.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":19490.47},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28923.54},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":36039.88},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9367.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8973.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17861.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9279.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":19434.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9358.35,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Abortion With D&C, Aspiration Curettage Or Hysterotomy","code_information":[{"code":"770","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9336.29,"maximum":37623.31,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34119.88},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9472.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21943.09},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":26543.47},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9381.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":20346.79},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30194.31},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":37623.31},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9746.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9336.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18584.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9655.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":20221.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9737.07,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":3343.05,"10th_percentile":3343.05,"90th_percentile":3343.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cesarean Section Without Sterilization Without Cc/Mcc","code_information":[{"code":"788","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8958.52,"maximum":35976.09,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32626.05},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9089.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20982.38},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":25381.35},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9002.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":19455.97},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28872.34},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":35976.09},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9351.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8958.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17832.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9264.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":19402.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9343.08,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":3244.64,"10th_percentile":3244.64,"90th_percentile":3244.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":21896.84,"10th_percentile":21896.84,"90th_percentile":21896.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25975.98,"10th_percentile":25975.98,"90th_percentile":25975.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":3399.15,"10th_percentile":3399.15,"90th_percentile":4343.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":3244.65,"10th_percentile":3244.65,"90th_percentile":3244.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Vaginal Delivery With Sterilization And/Or D&C With Mcc","code_information":[{"code":"796","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10750.14,"maximum":43788.17,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39710.68},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10907.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25538.63},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":30892.82},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10802.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":23680.76},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35141.87},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":43788.17},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11222.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10750.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21398.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11117.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":23283.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11211.61,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Traumatic Injury Without Mcc","code_information":[{"code":"914","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8327.76,"maximum":33225.73,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30131.79},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8449.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19378.28},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":23440.96},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8368.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":17968.57},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26665.06},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":33225.73},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8693.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8327.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16576.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8612.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":18036.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8685.24,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Aftercare Without Cc/Mcc","code_information":[{"code":"950","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6109.33,"maximum":23552.56,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21359.38},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6198.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13736.59},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":16616.47},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6139.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":12737.29},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18901.93},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":23552.56},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6377.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6109.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12160.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6317.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":13231.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6371.58,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Multiple Significant Trauma With Cc","code_information":[{"code":"964","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13896.21,"maximum":57506.22,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52151.31},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14099.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33539.42},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":40570.99},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13964.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":31099.52},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46151.18},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":57506.22},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14506.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13896.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27660.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14370.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":30097.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14492.73,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extensive O.R. Procedures Unrelated To Principal Diagnosis With Mcc","code_information":[{"code":"981","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":41081.92,"maximum":176045.72,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":159652.57},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41683.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":102675.35},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":124201.33},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41282.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":95206.01},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":141284.17},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":176045.72},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42885.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41081.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":81775.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42484.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":88977.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42845.43,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Vaginal Delivery With Sterilization And/Or D&C Without Cc/Mcc","code_information":[{"code":"798","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8943.89,"maximum":35912.31,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32568.2},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9074.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20945.18},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":25336.35},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8987.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":19421.47},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28821.15},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":35912.31},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9336.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8943.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17803.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9249.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":19371.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9327.83,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Procedures Without Cc/Mcc","code_information":[{"code":"830","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13658.71,"maximum":56470.61,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51212.14},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13858.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32935.42},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":39840.36},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13725.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":30539.46},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45320.07},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":56470.61},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14258.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13658.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27188.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14125.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29582.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14245.03,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc","code_information":[{"code":"846","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":23016.92,"maximum":97275.79,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":88217.59},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23353.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":56734.27},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":68628.66},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23129.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":52607.01},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":78067.95},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":97275.79},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24027.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23016.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":45816.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23802.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":49851.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24004.96,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hand Procedures For Injuries","code_information":[{"code":"906","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17611.1,"maximum":73704.46,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":66841.2},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17868.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42986.74},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":51998.95},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17697.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":39859.58},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":59150.97},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":73704.46},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18384.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17611.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":35055.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18212.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":38143.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18367.09,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Poisoning And Toxic Effects Of Drugs With Mcc","code_information":[{"code":"917","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14204.29,"maximum":58849.5,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53369.52},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14412.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34322.87},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":41518.68},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14273.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":31825.97},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":47229.23},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":58849.5},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14827.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14204.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28274.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14689.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":30764.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14814.03,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Menstrual And Other Female Reproductive System Disorders Without Cc/Mcc","code_information":[{"code":"761","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5617.1,"maximum":21406.3,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19412.97},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5699.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12484.82},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":15102.28},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5644.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":11576.59},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17179.47},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":21406.3},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5863.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5617.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11181.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5808.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":12165.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5858.23,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cesarean Section With Sterilization Without Cc/Mcc","code_information":[{"code":"785","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8949.92,"maximum":35938.57,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32592.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9080.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20960.5},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":25354.88},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8993.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":19435.68},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28842.23},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":35938.57},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9342.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8949.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17815.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9255.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":19384.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9334.11,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":26888.97,"10th_percentile":26888.97,"90th_percentile":26888.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Full Term Neonate With Major Problems","code_information":[{"code":"793","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":36588.26,"maximum":156451.73,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":141883.15},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37123.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":91247.53},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":110377.65},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36766.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":84609.52},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":125559.16},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":156451.73},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38194.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36588.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":72830.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37837.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":79244.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38158.87,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":909.25,"10th_percentile":909.25,"90th_percentile":909.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Splenic Procedures Without Cc/Mcc","code_information":[{"code":"801","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17134.37,"maximum":71625.75,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":64956.05},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17385.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":41774.37},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":50532.4},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17217.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":38735.4},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":57482.71},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":71625.75},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17886.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17134.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34106.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17719.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":37110.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17869.9,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Coagulation Disorders ","code_information":[{"code":"809","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11601.2,"maximum":47499.1,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43076.05},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11770.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27702.96},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":33510.9},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11657.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":25687.64},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":38120.05},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":47499.1},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12110.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11601.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23092.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11997.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":25126.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12099.2,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Antepartum Diagnoses With O.R. Procedures With Mcc","code_information":[{"code":"817","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":20341.55,"maximum":85610.2,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":77638.28},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20639.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":49930.53},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":60398.52},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20440.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":46298.23},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":68705.82},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":85610.2},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21234.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20341.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":40490.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21036.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":44056.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21214.74,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":6259.81,"10th_percentile":6259.81,"90th_percentile":6259.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lymphoma And Non-Acute Leukemia With Other Procedures Without Cc/Mcc","code_information":[{"code":"825","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12319.73,"maximum":50632.19,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45917.38},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12500.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29530.27},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":35721.32},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12379.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":27382.02},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40634.48},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":50632.19},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12860.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12319.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24522.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12740.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":26682.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12848.58,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Antepartum Diagnoses Without O.R. Procedures Without Cc/Mcc","code_information":[{"code":"833","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5207.5,"maximum":19620.25,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17793.24},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5283.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11443.14},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":13842.21},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5232.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":10610.69},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15746.09},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":19620.25},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5436.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5207.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10365.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5385.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":11278.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5431.04,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lymphoma And Non-Acute Leukemia With Cc","code_information":[{"code":"841","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14746.42,"maximum":61213.39,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55513.28},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14962.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35701.56},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":43186.42},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14818.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":33104.37},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":49126.35},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":61213.39},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15393.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14746.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29353.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15249.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":31938.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15379.44,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Radiotherapy","code_information":[{"code":"849","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":24023.73,"maximum":101665.86,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":92198.87},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24375.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":59294.7},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":71725.88},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24140.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":54981.17},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":81591.17},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":101665.86},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25078.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24023.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":47820.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24844.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":52031.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25055.0,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Postoperative And Post-Traumatic Infections With Mcc","code_information":[{"code":"862","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16401.2,"maximum":68428.87,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62056.86},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16641.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39909.85},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":48276.99},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16481.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":37006.52},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":54917.08},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":68428.87},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17121.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16401.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32647.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16961.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":35522.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17105.25,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":68428.87,"10th_percentile":68428.87,"90th_percentile":68428.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":9737.03,"10th_percentile":9737.03,"90th_percentile":9737.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Septicemia Or Severe Sepsis With Mv >96 Hours","code_information":[{"code":"870","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":60185.56,"maximum":259344.56,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":235194.73},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":61066.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":151257.83},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":182969.17},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":60479.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":140254.25},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":208135.03},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":259344.56},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":62827.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":60185.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":119801.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":62240.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":130353.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":62769.14,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":54447.22,"10th_percentile":54447.22,"90th_percentile":54447.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":50399.2,"10th_percentile":50399.2,"90th_percentile":50399.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Full Thickness Burn Without Skin Graft Or Inhalation Injury","code_information":[{"code":"934","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19730.57,"maximum":82946.13,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":75222.3},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20019.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":48376.77},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":58519.0},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19826.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":44857.5},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":66567.8},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":82946.13},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20596.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19730.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":39274.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20404.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":42733.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20577.54,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Signs And Symptoms Without Mcc","code_information":[{"code":"948","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7596.32,"maximum":30036.36,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27239.41},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7707.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17518.14},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":21190.84},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7633.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":16243.75},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24105.46},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":30036.36},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7929.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7596.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15120.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7855.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":16452.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7922.4,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6936.16,"10th_percentile":6936.16,"90th_percentile":6936.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other O.R. Procedures For Multiple Significant Trauma Without Cc/Mcc","code_information":[{"code":"959","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":26042.52,"maximum":110468.52,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":100181.83},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26423.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":64428.68},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":77936.22},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26169.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":59741.68},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":88655.68},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":110468.52},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27185.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26042.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":51838.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26931.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":56404.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27160.45,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hiv With Major Related Condition Without Cc/Mcc","code_information":[{"code":"976","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8475.77,"maximum":33871.11,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30717.08},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8599.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19754.69},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":23896.27},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8517.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":18317.59},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27183.01},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":33871.11},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8847.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8475.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16871.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8765.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":18357.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8839.6,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lymphoma And Non-Acute Leukemia Without Cc/Mcc","code_information":[{"code":"842","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9402.56,"maximum":37912.23,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34381.89},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9540.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22111.59},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":26747.31},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9448.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":20503.04},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30426.18},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":37912.23},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9815.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9402.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18716.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9723.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":20364.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9806.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":35029.51,"10th_percentile":35029.51,"90th_percentile":35029.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Leukemia With Other Procedures","code_information":[{"code":"850","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":75224.96,"maximum":324921.76,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":294665.47},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":76325.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":189504.5},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":229234.28},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":75591.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":175718.57},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":260763.52},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":324921.76},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":78527.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":75224.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":149738.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":77793.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":162926.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":78454.12,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Organic Disturbances And Intellectual Disability","code_information":[{"code":"884","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14552.8,"maximum":60369.15,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":54747.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14765.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35209.17},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":42590.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14623.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":32647.8},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":48448.81},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":60369.15},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15191.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14552.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28967.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15049.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":31519.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15177.5,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Wound Debridements For Injuries With Mcc","code_information":[{"code":"901","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":36820.59,"maximum":157464.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":142801.9},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37359.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":91838.39},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":111092.4},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37000.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":85157.41},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":126372.22},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":157464.83},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38437.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36820.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":73292.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38077.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":79748.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38401.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":33945.42,"10th_percentile":33945.42,"90th_percentile":33945.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other O.R. Procedures For Injuries Without Cc/Mcc","code_information":[{"code":"909","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12003.92,"maximum":49255.13,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44668.56},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12179.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28727.13},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":34749.79},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12062.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":26637.31},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39529.34},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":49255.13},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12530.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12003.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23894.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12413.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":25998.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12519.21,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Female Reproductive System O.R. Procedures Without Cc/Mcc","code_information":[{"code":"750","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13407.44,"maximum":55374.97,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50218.52},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13603.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32296.41},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":39067.38},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13472.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":29946.93},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":44440.77},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":55374.97},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13996.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13407.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26688.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13865.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":29038.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13982.98,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"1 through 10","median_amount":19794.34,"10th_percentile":19794.34,"90th_percentile":19794.34},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Digestive System O.R. Procedures Without Cc/Mcc","code_information":[{"code":"358","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12737.09,"maximum":52452.0,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47567.74},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12923.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30591.64},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":37005.21},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12799.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":28366.19},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42094.96},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":52452.0},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13296.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12737.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25353.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13172.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":27586.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13283.85,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inguinal And Femoral Hernia Procedures With Mcc","code_information":[{"code":"350","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":22151.23,"maximum":93501.07,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":84794.37},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22475.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":54532.74},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":65965.58},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22259.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":50565.63},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":75038.58},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":93501.07},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23123.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22151.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":44092.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22907.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":47976.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23102.12,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Peritoneal Adhesiolysis With Cc","code_information":[{"code":"336","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18853.7,"maximum":79122.64,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":71754.84},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19129.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46146.79},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":55821.51},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18945.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":42789.74},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":63499.28},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":79122.64},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19681.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18853.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37528.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19497.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":40834.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19663.03,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Stomach, Esophageal And Duodenal Procedures Without Cc/Mcc","code_information":[{"code":"328","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14496.0,"maximum":60121.5,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":54523.06},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14708.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35064.73},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":42416.09},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14566.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":32513.87},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":48250.06},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":60121.5},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15132.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14496.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28854.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14990.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":31396.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15118.27,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Endovascular Cardiac Valve Procedures Without Mcc","code_information":[{"code":"320","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21406.02,"maximum":90251.67,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":81847.55},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21719.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":52637.59},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":63673.1},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21510.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":48808.35},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":72430.8},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":90251.67},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22345.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21406.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":42609.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22136.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":46362.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22324.91,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Syncope And Collapse","code_information":[{"code":"312","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8208.15,"maximum":32704.18,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29658.8},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8328.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19074.09},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":23073.0},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8248.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":17686.51},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26246.49},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":32704.18},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8568.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8208.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16338.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8488.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17777.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8560.5,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":3130.29,"10th_percentile":3130.29,"90th_percentile":3130.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":5897.21,"10th_percentile":5897.21,"90th_percentile":5897.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hypertension With Mcc","code_information":[{"code":"304","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10948.06,"maximum":44651.18,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40493.32},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11108.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26041.96},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":31501.68},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11001.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":24147.48},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35834.47},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":44651.18},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11428.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10948.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21792.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11321.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":23711.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11418.02,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Arrest, Unexplained With Mcc","code_information":[{"code":"296","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14148.35,"maximum":58605.61,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53148.33},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14355.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34180.62},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":41346.62},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14217.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":31694.07},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":47033.49},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":58605.61},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14769.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14148.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28162.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14631.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":30643.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14755.7,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc","code_information":[{"code":"286","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19749.51,"maximum":83028.68,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":75297.16},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20038.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":48424.92},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":58577.24},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19845.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":44902.14},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":66634.05},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":83028.68},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20616.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19749.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":39312.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20423.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":42774.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20597.29,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":16404.55,"10th_percentile":16404.55,"90th_percentile":16404.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures With Mcc","code_information":[{"code":"278","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":48606.34,"maximum":208854.96,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":189406.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49317.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":121810.72},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":147348.45},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48843.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":112949.33},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":167614.98},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":208854.96},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50740.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48606.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":96752.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50266.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":105274.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50692.86,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Major Cardiovascular Procedures With Mcc","code_information":[{"code":"270","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":46111.69,"maximum":197977.33,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":179541.94},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46786.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":115466.55},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":139674.21},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46336.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":107066.68},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":158885.22},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":197977.33},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48136.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46111.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":91787.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":47686.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":99871.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48091.11,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":40453.18,"10th_percentile":40453.18,"90th_percentile":40453.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Pacemaker Revision Except Device Replacement Without Cc/Mcc","code_information":[{"code":"262","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14733.5,"maximum":61157.11,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55462.24},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14949.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35668.73},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":43146.71},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14805.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":33073.93},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":49081.18},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":61157.11},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15380.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14733.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29327.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15236.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":31910.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15365.97,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":35840.52,"10th_percentile":35840.52,"90th_percentile":35840.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extreme Immaturity Or Respiratory Distress Syndrome, Neonate","code_information":[{"code":"790","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":51853.1,"maximum":223012.01,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":202245.42},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52611.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":130067.55},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":157336.33},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52106.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":120605.5},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":178976.62},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":223012.01},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54129.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51853.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":103215.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53623.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":112306.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54078.99,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Abortion Without D&C","code_information":[{"code":"779","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7947.41,"maximum":31567.26,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28627.76},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8063.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18411.01},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":22270.89},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7986.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":17071.66},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25334.07},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":31567.26},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8296.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7947.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15819.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8218.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":17212.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8288.57,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":2862.35,"10th_percentile":2862.35,"90th_percentile":2862.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Infections, Female Reproductive System With Cc","code_information":[{"code":"758","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9132.35,"maximum":36734.04,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33313.41},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9265.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21424.44},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":25916.09},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9176.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":19865.87},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29480.63},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":36734.04},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9533.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9132.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18178.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9444.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":19779.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9524.37,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Non-Extensive O.R. Procedures Unrelated To Principal Diagnosis With Mcc","code_information":[{"code":"987","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":30210.04,"maximum":128640.42,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":116661.6},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30652.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":75027.11},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":90756.6},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30357.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":69569.09},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":103239.41},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":128640.42},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31536.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30210.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":60134.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31241.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":65430.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31506.86,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23639.4,"10th_percentile":23639.4,"90th_percentile":23639.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hiv With Extensive O.R. Procedures Without Mcc","code_information":[{"code":"970","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":23403.29,"maximum":98960.52,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":89745.45},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23745.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":57716.86},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":69817.25},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23517.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":53518.12},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":79420.03},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":98960.52},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24430.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23403.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":46585.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24202.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":50688.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24407.92,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma","code_information":[{"code":"956","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":33089.36,"maximum":141195.29,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":128047.36},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33573.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":82349.49},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":99614.14},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33250.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":76358.8},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":113315.22},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":141195.29},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34542.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33089.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":65865.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34219.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":71666.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34509.78,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":73836.22,"10th_percentile":73836.22,"90th_percentile":73836.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Rehabilitation With Cc/Mcc","code_information":[{"code":"945","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14033.9,"maximum":58106.57,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52695.76},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14239.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33889.56},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":40994.54},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14102.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":31424.19},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46632.99},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":58106.57},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14650.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14033.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27934.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14513.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":30395.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14636.33,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Depressive Neuroses","code_information":[{"code":"881","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8804.49,"maximum":35304.45,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32016.95},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8933.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20590.66},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":24907.5},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8847.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":19092.74},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28333.32},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":35304.45},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9191.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8804.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17525.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9105.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":19069.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9182.44,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Infectious And Parasitic Diseases Diagnoses With Mcc","code_information":[{"code":"867","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18720.32,"maximum":78541.05,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":71227.41},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18994.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45807.59},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":55411.19},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18811.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":42475.21},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":63032.53},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":78541.05},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19542.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18720.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37263.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19359.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":40545.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19523.93,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":16688.71,"10th_percentile":16688.71,"90th_percentile":16688.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Postoperative Or Post-Traumatic Infections With O.R. Procedures With Mcc","code_information":[{"code":"856","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":39850.5,"maximum":170676.32,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":154783.16},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40433.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":99543.75},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":120413.19},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40044.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":92302.22},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":136975.0},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":170676.32},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41600.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39850.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":79323.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41211.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":86310.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41561.16,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lymphoma And Leukemia With Major O.R. Procedures Without Cc/Mcc","code_information":[{"code":"822","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11068.53,"maximum":45176.49,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40969.71},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11230.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26348.34},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":31872.29},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11122.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":24431.57},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36256.05},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":45176.49},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11554.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11068.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22032.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11446.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":23972.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11543.67,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Reticuloendothelial And Immunity Disorders With Mcc","code_information":[{"code":"814","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19008.59,"maximum":79798.04,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":72367.35},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19286.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46540.7},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":56298.0},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19101.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":43155.0},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":64041.32},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":79798.04},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19843.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19008.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37837.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19657.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":41169.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19824.57,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Vaginal Delivery Without Sterilization Or D&C With Cc","code_information":[{"code":"806","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7196.17,"maximum":28291.59,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25657.11},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7301.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16500.54},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":19959.89},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7231.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":15300.17},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22705.2},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":28291.59},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7512.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7196.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14324.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7441.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":15585.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7505.07,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"1 through 10","median_amount":11971.0,"10th_percentile":11971.0,"90th_percentile":11971.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2239.66,"10th_percentile":2239.66,"90th_percentile":2239.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"1 through 10","median_amount":16022.58,"10th_percentile":16022.58,"90th_percentile":16022.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2260.99,"10th_percentile":2260.99,"90th_percentile":2260.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14986.31,"10th_percentile":14986.31,"90th_percentile":14986.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"1 through 10","median_amount":2346.31,"10th_percentile":2346.31,"90th_percentile":2346.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Traumatic Injury With Mcc","code_information":[{"code":"913","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14773.95,"maximum":61333.46,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55622.17},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14990.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35771.59},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":43271.13},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14846.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":33169.3},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":49222.71},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":61333.46},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15422.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14773.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29408.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15278.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":31998.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15408.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Complications Of Treatment Without Cc/Mcc","code_information":[{"code":"921","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6631.67,"maximum":25830.14,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23424.88},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6728.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15064.95},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":18223.32},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6664.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":13969.01},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20729.79},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":25830.14},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6922.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6631.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13200.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6858.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":14363.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6916.34,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Non-Extensive Burns","code_information":[{"code":"935","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18434.62,"maximum":77295.32,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":70097.68},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18704.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45081.04},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":54532.32},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18524.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":41801.52},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":62032.78},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":77295.32},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19243.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18434.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":36694.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19064.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":39926.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19225.96,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Aftercare With Cc/Mcc","code_information":[{"code":"949","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10945.47,"maximum":44639.92,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40483.11},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11105.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26035.39},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":31493.74},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10998.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":24141.39},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35825.44},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":44639.92},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11426.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10945.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21787.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11319.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":23706.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11415.33,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Multiple Significant Trauma With Mcc","code_information":[{"code":"963","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":24232.84,"maximum":102577.64,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":93025.75},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24587.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":59826.48},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":72369.15},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24351.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":55474.27},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":82322.92},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":102577.64},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25296.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24232.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":48236.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25060.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":52484.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25273.08,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hiv With Or Without Other Related Condition","code_information":[{"code":"977","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11874.84,"maximum":48692.3,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44158.14},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12048.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28398.87},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"fee schedule","standard_charge_dollar":34352.71},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11932.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"fee schedule","standard_charge_dollar":26332.93},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39077.64},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"fee schedule","standard_charge_dollar":48692.3},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12396.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11874.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23637.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12280.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"fee schedule","standard_charge_dollar":25719.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12384.59,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ketorolac tromethamine inj","code_information":[{"code":"0764","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":144.57,"10th_percentile":144.57,"90th_percentile":144.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inj cefazolin sodium, hikma","code_information":[{"code":"0788","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":10.87,"10th_percentile":10.87,"90th_percentile":10.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":4.11,"10th_percentile":4.11,"90th_percentile":4.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Clinic Visits and Related Services","code_information":[{"code":"5012","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":161.37,"10th_percentile":19.91,"90th_percentile":530.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":122.27,"10th_percentile":122.27,"90th_percentile":184.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":131.84,"10th_percentile":131.84,"90th_percentile":131.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"13","median_amount":449.47,"10th_percentile":216.57,"90th_percentile":802.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":133.24,"10th_percentile":133.24,"90th_percentile":133.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":118.54,"10th_percentile":117.03,"90th_percentile":169.12},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":131.26,"10th_percentile":131.26,"90th_percentile":131.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":90.08,"10th_percentile":90.08,"90th_percentile":170.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"19","median_amount":165.11,"10th_percentile":119.81,"90th_percentile":200.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"25","median_amount":133.66,"10th_percentile":133.66,"90th_percentile":133.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Type A ED Visits","code_information":[{"code":"5021","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":537.52,"10th_percentile":537.52,"90th_percentile":537.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":91.92,"10th_percentile":91.92,"90th_percentile":91.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":320.68,"10th_percentile":320.68,"90th_percentile":326.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":91.03,"10th_percentile":91.03,"90th_percentile":91.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":86.49,"10th_percentile":86.49,"90th_percentile":86.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":196.2,"10th_percentile":196.2,"90th_percentile":196.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":119.47,"10th_percentile":119.47,"90th_percentile":212.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":92.8,"10th_percentile":92.8,"90th_percentile":92.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Type A ED Visits","code_information":[{"code":"5022","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":1093.85,"10th_percentile":1093.85,"90th_percentile":1093.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":157.02,"10th_percentile":105.33,"90th_percentile":269.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":164.51,"10th_percentile":164.21,"90th_percentile":164.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"1 through 10","median_amount":906.8,"10th_percentile":906.8,"90th_percentile":906.8},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"16","median_amount":531.77,"10th_percentile":511.92,"90th_percentile":831.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":163.73,"10th_percentile":163.73,"90th_percentile":163.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":825.86,"10th_percentile":825.86,"90th_percentile":2765.73},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":341.76,"10th_percentile":341.76,"90th_percentile":341.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"25","median_amount":142.46,"10th_percentile":99.76,"90th_percentile":200.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"20","median_amount":352.89,"10th_percentile":352.89,"90th_percentile":352.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"92","median_amount":122.92,"10th_percentile":91.38,"90th_percentile":212.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"11","median_amount":632.25,"10th_percentile":166.07,"90th_percentile":632.25},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"23","median_amount":70.11,"10th_percentile":66.77,"90th_percentile":165.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Type A ED Visits","code_information":[{"code":"5023","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"15","median_amount":1651.6,"10th_percentile":627.43,"90th_percentile":2830.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"28","median_amount":147.32,"10th_percentile":109.13,"90th_percentile":280.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"17","median_amount":285.28,"10th_percentile":283.28,"90th_percentile":286.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"43","median_amount":1347.11,"10th_percentile":794.73,"90th_percentile":3014.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"13","median_amount":286.28,"10th_percentile":286.28,"90th_percentile":449.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"1 through 10","median_amount":2158.06,"10th_percentile":2158.06,"90th_percentile":2158.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"18","median_amount":2325.7,"10th_percentile":1267.14,"90th_percentile":2993.16},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"1 through 10","median_amount":297.4,"10th_percentile":297.4,"90th_percentile":297.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":283.09,"10th_percentile":283.09,"90th_percentile":283.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":581.3,"10th_percentile":581.3,"90th_percentile":581.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"94","median_amount":148.72,"10th_percentile":106.33,"90th_percentile":218.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":291.43,"10th_percentile":291.43,"90th_percentile":291.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"87","median_amount":617.03,"10th_percentile":617.03,"90th_percentile":933.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"284","median_amount":150.53,"10th_percentile":112.35,"90th_percentile":212.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"14","median_amount":1524.63,"10th_percentile":973.75,"90th_percentile":2390.16},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"110","median_amount":287.39,"10th_percentile":133.54,"90th_percentile":288.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Type A ED Visits","code_information":[{"code":"5024","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"51","median_amount":2761.13,"10th_percentile":1403.01,"90th_percentile":6799.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"34","median_amount":194.06,"10th_percentile":115.24,"90th_percentile":408.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"50","median_amount":588.86,"10th_percentile":438.14,"90th_percentile":894.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"120","median_amount":3584.2,"10th_percentile":1993.8,"90th_percentile":10265.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"26","median_amount":550.19,"10th_percentile":440.25,"90th_percentile":768.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"1 through 10","median_amount":3022.46,"10th_percentile":2338.86,"90th_percentile":9547.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"43","median_amount":3935.48,"10th_percentile":2927.93,"90th_percentile":11082.25},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"1 through 10","median_amount":644.1,"10th_percentile":644.1,"90th_percentile":644.1},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"1 through 10","median_amount":712.36,"10th_percentile":712.36,"90th_percentile":712.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":948.91,"10th_percentile":948.91,"90th_percentile":948.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1373.67,"10th_percentile":1373.67,"90th_percentile":1373.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"81","median_amount":171.42,"10th_percentile":107.84,"90th_percentile":513.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":760.25,"10th_percentile":447.06,"90th_percentile":825.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"192","median_amount":1419.07,"10th_percentile":948.89,"90th_percentile":2060.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"251","median_amount":212.27,"10th_percentile":119.47,"90th_percentile":513.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"77","median_amount":2896.71,"10th_percentile":589.08,"90th_percentile":5994.84},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"156","median_amount":533.7,"10th_percentile":214.49,"90th_percentile":909.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 5 Type A ED Visits","code_information":[{"code":"5025","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"44","median_amount":6214.56,"10th_percentile":1730.93,"90th_percentile":17369.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":508.84,"10th_percentile":280.71,"90th_percentile":721.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"41","median_amount":1074.61,"10th_percentile":633.75,"90th_percentile":2808.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"86","median_amount":9407.71,"10th_percentile":4550.93,"90th_percentile":16282.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"18","median_amount":1364.04,"10th_percentile":942.74,"90th_percentile":2767.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"1 through 10","median_amount":16182.13,"10th_percentile":16182.13,"90th_percentile":17377.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"25","median_amount":13083.82,"10th_percentile":6473.02,"90th_percentile":19811.82},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"1 through 10","median_amount":1377.89,"10th_percentile":1377.89,"90th_percentile":1377.89},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":1845.76,"10th_percentile":1845.76,"90th_percentile":1845.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2076.57,"10th_percentile":2076.57,"90th_percentile":2076.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"30","median_amount":405.38,"10th_percentile":135.28,"90th_percentile":768.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2785.63,"10th_percentile":2785.63,"90th_percentile":2785.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"124","median_amount":2268.9,"10th_percentile":1775.25,"90th_percentile":3180.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"77","median_amount":388.87,"10th_percentile":150.36,"90th_percentile":774.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"46","median_amount":5741.94,"10th_percentile":1037.15,"90th_percentile":13887.58},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"113","median_amount":1093.89,"10th_percentile":724.21,"90th_percentile":2750.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Critical Care","code_information":[{"code":"5041","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":9608.58,"10th_percentile":9608.58,"90th_percentile":9608.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":836.27,"10th_percentile":836.27,"90th_percentile":836.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1546.68,"10th_percentile":1546.68,"90th_percentile":11337.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":21691.14,"10th_percentile":18111.89,"90th_percentile":30908.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":1757.38,"10th_percentile":1757.38,"90th_percentile":5333.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"1 through 10","median_amount":4330.57,"10th_percentile":4330.57,"90th_percentile":4330.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4296.49,"10th_percentile":4296.49,"90th_percentile":4296.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":477.35,"10th_percentile":477.35,"90th_percentile":1154.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5900.18,"10th_percentile":4062.41,"90th_percentile":5973.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":619.94,"10th_percentile":496.02,"90th_percentile":3842.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":21188.57,"10th_percentile":6586.25,"90th_percentile":23343.72},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"13","median_amount":1326.01,"10th_percentile":1135.61,"90th_percentile":2918.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Skin Procedures","code_information":[{"code":"5051","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":79.8,"10th_percentile":79.8,"90th_percentile":79.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":642.24,"10th_percentile":327.47,"90th_percentile":776.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":442.78,"10th_percentile":442.78,"90th_percentile":795.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":767.3,"10th_percentile":767.3,"90th_percentile":767.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":206.07,"10th_percentile":206.07,"90th_percentile":206.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Skin Procedures","code_information":[{"code":"5052","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":511.55,"10th_percentile":511.55,"90th_percentile":511.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":266.75,"10th_percentile":266.75,"90th_percentile":266.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":546.08,"10th_percentile":546.08,"90th_percentile":546.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":2936.05,"10th_percentile":2129.04,"90th_percentile":2936.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":576.8,"10th_percentile":576.8,"90th_percentile":576.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":414.96,"10th_percentile":267.32,"90th_percentile":414.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":701.17,"10th_percentile":701.17,"90th_percentile":701.17},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":414.35,"10th_percentile":412.67,"90th_percentile":700.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Skin Procedures","code_information":[{"code":"5053","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":392.73,"10th_percentile":392.73,"90th_percentile":392.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":1003.24,"10th_percentile":1003.24,"90th_percentile":1003.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Skin Procedures","code_information":[{"code":"5054","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":2053.86,"10th_percentile":2053.86,"90th_percentile":2053.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Excision/ Biopsy/ Incision and Drainage","code_information":[{"code":"5071","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":725.31,"10th_percentile":725.31,"90th_percentile":725.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":3049.99,"10th_percentile":963.6,"90th_percentile":3161.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":8636.83,"10th_percentile":8636.83,"90th_percentile":8636.83},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1567.88,"10th_percentile":1567.88,"90th_percentile":1567.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":452.13,"10th_percentile":452.13,"90th_percentile":452.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":729.73,"10th_percentile":729.73,"90th_percentile":729.73},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":729.69,"10th_percentile":729.69,"90th_percentile":729.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Excision/ Biopsy/ Incision and Drainage","code_information":[{"code":"5072","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":2914.18,"10th_percentile":2006.37,"90th_percentile":12377.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1663.08,"10th_percentile":1659.08,"90th_percentile":1664.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":6810.8,"10th_percentile":5291.37,"90th_percentile":10184.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":1675.15,"10th_percentile":1675.15,"90th_percentile":1675.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":8073.1,"10th_percentile":8073.1,"90th_percentile":8073.1},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3610.52,"10th_percentile":3610.52,"90th_percentile":3697.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":928.13,"10th_percentile":928.13,"90th_percentile":1392.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":9055.02,"10th_percentile":4024.88,"90th_percentile":12898.23},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":1680.36,"10th_percentile":1680.36,"90th_percentile":1684.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Excision/ Biopsy/ Incision and Drainage","code_information":[{"code":"5073","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":18235.79,"10th_percentile":18235.79,"90th_percentile":18235.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":21728.65,"10th_percentile":21728.65,"90th_percentile":21728.65},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":1652.75,"10th_percentile":1652.75,"90th_percentile":1652.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":19996.52,"10th_percentile":19996.52,"90th_percentile":19996.52},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2972.38,"10th_percentile":2972.38,"90th_percentile":2976.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Strapping and Cast Application","code_information":[{"code":"5101","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":738.71,"10th_percentile":738.71,"90th_percentile":738.71},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":245.48,"10th_percentile":245.48,"90th_percentile":245.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Musculoskeletal Procedures","code_information":[{"code":"5112","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":1654.65,"10th_percentile":1654.65,"90th_percentile":1654.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":699.35,"10th_percentile":699.35,"90th_percentile":699.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":1659.79,"10th_percentile":1655.24,"90th_percentile":1668.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Musculoskeletal Procedures","code_information":[{"code":"5113","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3328.04,"10th_percentile":3328.04,"90th_percentile":3328.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":200.0,"10th_percentile":200.0,"90th_percentile":200.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7230.25,"10th_percentile":7230.25,"90th_percentile":7230.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":32555.81,"10th_percentile":32555.81,"90th_percentile":32555.81},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Musculoskeletal Procedures","code_information":[{"code":"5114","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":11379.39,"10th_percentile":11379.39,"90th_percentile":52253.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":3721.15,"10th_percentile":3721.15,"90th_percentile":3721.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7329.72,"10th_percentile":7329.72,"90th_percentile":7329.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":13606.3,"10th_percentile":13606.3,"90th_percentile":13606.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":4252.74,"10th_percentile":4252.74,"90th_percentile":4252.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":138.91,"10th_percentile":138.91,"90th_percentile":138.91},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":7541.78,"10th_percentile":7541.78,"90th_percentile":7541.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 5 Musculoskeletal Procedures","code_information":[{"code":"5115","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":33365.98,"10th_percentile":33365.98,"90th_percentile":33365.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":7737.44,"10th_percentile":7737.44,"90th_percentile":7737.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":6463.56,"10th_percentile":6463.56,"90th_percentile":6463.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 6 Musculoskeletal Procedures","code_information":[{"code":"5116","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":18921.43,"10th_percentile":18921.43,"90th_percentile":19027.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Airway Endoscopy","code_information":[{"code":"5154","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":10291.68,"10th_percentile":10291.68,"90th_percentile":10291.68},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 5 Airway Endoscopy","code_information":[{"code":"5155","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":7183.46,"10th_percentile":7183.46,"90th_percentile":7183.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 ENT Procedures","code_information":[{"code":"5163","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":13709.97,"10th_percentile":13709.97,"90th_percentile":13709.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 5 ENT Procedures","code_information":[{"code":"5165","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":20859.97,"10th_percentile":20859.97,"90th_percentile":20859.97},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Vascular Procedures","code_information":[{"code":"5181","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":411.14,"10th_percentile":162.95,"90th_percentile":1601.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":638.31,"10th_percentile":638.31,"90th_percentile":638.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":1311.75,"10th_percentile":1311.75,"90th_percentile":1311.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":2294.87,"10th_percentile":2294.87,"90th_percentile":2294.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"1 through 10","median_amount":664.04,"10th_percentile":664.04,"90th_percentile":664.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":638.6,"10th_percentile":638.6,"90th_percentile":638.6},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":957.9,"10th_percentile":641.2,"90th_percentile":2529.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Vascular Procedures","code_information":[{"code":"5182","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":6755.88,"10th_percentile":6755.88,"90th_percentile":6755.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":1610.14,"10th_percentile":1610.14,"90th_percentile":1610.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Vascular Procedures","code_information":[{"code":"5183","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":2708.61,"10th_percentile":2708.61,"90th_percentile":2708.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":3262.28,"10th_percentile":3262.28,"90th_percentile":3262.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":14517.33,"10th_percentile":14517.33,"90th_percentile":14517.33},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7022.59,"10th_percentile":7022.59,"90th_percentile":7022.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":21100.88,"10th_percentile":21100.88,"90th_percentile":21100.88},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":3264.29,"10th_percentile":3264.29,"90th_percentile":3268.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Vascular Procedures","code_information":[{"code":"5184","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":5587.62,"10th_percentile":5587.62,"90th_percentile":5587.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Endovascular Procedures","code_information":[{"code":"5191","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3300.63,"10th_percentile":3298.46,"90th_percentile":3404.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":17724.97,"10th_percentile":17724.97,"90th_percentile":17724.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"1 through 10","median_amount":18410.67,"10th_percentile":18410.67,"90th_percentile":18410.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":30654.45,"10th_percentile":30654.45,"90th_percentile":30654.45},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":12944.74,"10th_percentile":12944.74,"90th_percentile":12944.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":1672.49,"10th_percentile":1672.49,"90th_percentile":1672.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":18998.33,"10th_percentile":18998.33,"90th_percentile":18998.33},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":3339.89,"10th_percentile":3166.2,"90th_percentile":5917.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Endovascular Procedures","code_information":[{"code":"5192","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":5894.76,"10th_percentile":5894.76,"90th_percentile":5894.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":12705.22,"10th_percentile":12705.22,"90th_percentile":12705.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":5896.09,"10th_percentile":5896.09,"90th_percentile":5896.09},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Endovascular Procedures","code_information":[{"code":"5193","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":11607.5,"10th_percentile":11607.0,"90th_percentile":11803.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":62331.54,"10th_percentile":62331.54,"90th_percentile":62331.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":11724.94,"10th_percentile":11724.94,"90th_percentile":11724.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":83584.49,"10th_percentile":83584.49,"90th_percentile":83584.49},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"1 through 10","median_amount":22497.32,"10th_percentile":22497.32,"90th_percentile":22497.32},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":5911.73,"10th_percentile":5911.73,"90th_percentile":5911.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":25483.92,"10th_percentile":25483.92,"90th_percentile":25483.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":11746.58,"10th_percentile":11717.69,"90th_percentile":11761.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Endovascular Procedures","code_information":[{"code":"5194","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":18565.34,"10th_percentile":18565.34,"90th_percentile":18565.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":19087.01,"10th_percentile":19087.01,"90th_percentile":19087.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Electrophysiologic Procedures","code_information":[{"code":"5213","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":26690.47,"10th_percentile":26690.47,"90th_percentile":26690.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":93565.75,"10th_percentile":93565.75,"90th_percentile":93565.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":26498.48,"10th_percentile":26498.48,"90th_percentile":26498.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":25346.2,"10th_percentile":25346.2,"90th_percentile":25346.2},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Pacemaker and Similar Procedures","code_information":[{"code":"5222","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":8556.48,"10th_percentile":8556.48,"90th_percentile":8556.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":5201.63,"10th_percentile":5201.63,"90th_percentile":5201.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":8551.67,"10th_percentile":8551.67,"90th_percentile":8551.67},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":8583.06,"10th_percentile":8583.06,"90th_percentile":8583.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Pacemaker and Similar Procedures","code_information":[{"code":"5223","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":10717.51,"10th_percentile":10717.51,"90th_percentile":10717.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"1 through 10","median_amount":16776.46,"10th_percentile":16776.46,"90th_percentile":16776.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":10228.11,"10th_percentile":10228.11,"90th_percentile":10228.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 ICD and Similar Procedures","code_information":[{"code":"5232","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":4.05,"10th_percentile":4.05,"90th_percentile":4.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Blood Product Exchange and Related Services","code_information":[{"code":"5241","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":638.09,"10th_percentile":638.09,"90th_percentile":638.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"1 through 10","median_amount":669.91,"10th_percentile":669.91,"90th_percentile":669.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1389.9,"10th_percentile":1389.9,"90th_percentile":1389.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":4938.62,"10th_percentile":4938.62,"90th_percentile":4938.62},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":640.55,"10th_percentile":640.55,"90th_percentile":831.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Upper GI Procedures","code_information":[{"code":"5301","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":2115.47,"10th_percentile":2115.47,"90th_percentile":2115.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":2401.78,"10th_percentile":1864.23,"90th_percentile":7544.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":1444.69,"10th_percentile":1444.69,"90th_percentile":1458.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":8298.52,"10th_percentile":8298.52,"90th_percentile":8298.52},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":687.92,"10th_percentile":687.92,"90th_percentile":687.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2089.24,"10th_percentile":2089.24,"90th_percentile":2089.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":681.43,"10th_percentile":681.43,"90th_percentile":681.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":974.0,"10th_percentile":974.0,"90th_percentile":974.0},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"12","median_amount":972.35,"10th_percentile":972.35,"90th_percentile":980.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Upper GI Procedures","code_information":[{"code":"5302","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":1630.34,"10th_percentile":1630.34,"90th_percentile":1630.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":9411.52,"10th_percentile":9411.52,"90th_percentile":9411.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":1965.33,"10th_percentile":1965.33,"90th_percentile":1965.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":6479.41,"10th_percentile":6479.41,"90th_percentile":6479.41},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Lower GI Procedures","code_information":[{"code":"5311","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":1563.54,"10th_percentile":1563.54,"90th_percentile":1563.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":5647.6,"10th_percentile":5647.6,"90th_percentile":7431.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":942.61,"10th_percentile":942.61,"90th_percentile":942.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":668.72,"10th_percentile":668.72,"90th_percentile":668.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":945.83,"10th_percentile":945.83,"90th_percentile":945.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Lower GI Procedures","code_information":[{"code":"5312","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":2031.4,"10th_percentile":1740.06,"90th_percentile":9952.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1686.46,"10th_percentile":1686.46,"90th_percentile":1686.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":7634.76,"10th_percentile":6745.21,"90th_percentile":8711.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":1219.05,"10th_percentile":1219.05,"90th_percentile":1219.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":11729.52,"10th_percentile":11729.52,"90th_percentile":11729.52},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":1787.18,"10th_percentile":1787.18,"90th_percentile":1787.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3993.69,"10th_percentile":3993.69,"90th_percentile":3993.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2543.39,"10th_percentile":2543.39,"90th_percentile":2543.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Abdominal/Peritoneal/Biliary and Related Procedures","code_information":[{"code":"5341","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":9047.54,"10th_percentile":9047.54,"90th_percentile":9047.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3611.92,"10th_percentile":3611.92,"90th_percentile":3611.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":38525.94,"10th_percentile":38525.94,"90th_percentile":38525.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":16126.88,"10th_percentile":16126.88,"90th_percentile":16126.88},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Abdominal/Peritoneal/Biliary and Related Procedures","code_information":[{"code":"5342","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6389.09,"10th_percentile":6389.09,"90th_percentile":6389.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Laparoscopy and Related Services","code_information":[{"code":"5361","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":25725.45,"10th_percentile":14954.59,"90th_percentile":37057.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5972.22,"10th_percentile":5972.22,"90th_percentile":5972.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":30226.86,"10th_percentile":25575.46,"90th_percentile":49785.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":6032.72,"10th_percentile":6032.72,"90th_percentile":6032.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"1 through 10","median_amount":51923.11,"10th_percentile":51923.11,"90th_percentile":51923.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":42497.3,"10th_percentile":42497.3,"90th_percentile":42497.3},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":3456.55,"10th_percentile":3456.55,"90th_percentile":3456.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":16658.78,"10th_percentile":16658.78,"90th_percentile":16658.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2673.66,"10th_percentile":2673.66,"90th_percentile":3556.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":51344.5,"10th_percentile":41321.52,"90th_percentile":56817.72},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":5675.77,"10th_percentile":5675.77,"90th_percentile":6050.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Laparoscopy and Related Services","code_information":[{"code":"5362","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":42611.0,"10th_percentile":42611.0,"90th_percentile":50122.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":10764.71,"10th_percentile":10764.71,"90th_percentile":10764.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":46823.57,"10th_percentile":46823.57,"90th_percentile":46823.57},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":23201.62,"10th_percentile":23201.62,"90th_percentile":23202.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":3996.79,"10th_percentile":3996.79,"90th_percentile":3996.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":49517.87,"10th_percentile":49517.87,"90th_percentile":49517.87},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Urology and Related Services","code_information":[{"code":"5371","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":894.86,"10th_percentile":894.86,"90th_percentile":894.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":417.08,"10th_percentile":417.08,"90th_percentile":417.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Urology and Related Services","code_information":[{"code":"5372","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":689.42,"10th_percentile":689.42,"90th_percentile":689.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Urology and Related Services","code_information":[{"code":"5373","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2101.23,"10th_percentile":2100.74,"90th_percentile":2105.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":11738.11,"10th_percentile":11738.11,"90th_percentile":11738.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":2121.99,"10th_percentile":2121.99,"90th_percentile":2121.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4564.88,"10th_percentile":4564.88,"90th_percentile":4564.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":12163.17,"10th_percentile":12163.17,"90th_percentile":12163.17},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2124.51,"10th_percentile":2124.51,"90th_percentile":2128.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Urology and Related Services","code_information":[{"code":"5374","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":45088.26,"10th_percentile":45088.26,"90th_percentile":45088.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7685.66,"10th_percentile":7685.66,"90th_percentile":7685.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":1072.92,"10th_percentile":1072.92,"90th_percentile":1609.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":3573.51,"10th_percentile":3573.51,"90th_percentile":3573.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 5 Urology and Related Services","code_information":[{"code":"5375","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5210.92,"10th_percentile":5210.92,"90th_percentile":5222.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":5264.03,"10th_percentile":5264.03,"90th_percentile":5264.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2859.03,"10th_percentile":2859.03,"90th_percentile":2859.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":5257.03,"10th_percentile":5257.03,"90th_percentile":5257.03},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":5272.25,"10th_percentile":5272.25,"90th_percentile":5288.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 6 Urology and Related Services","code_information":[{"code":"5376","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":9468.33,"10th_percentile":9468.33,"90th_percentile":9468.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":37733.05,"10th_percentile":37733.05,"90th_percentile":37733.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":64687.24,"10th_percentile":64687.24,"90th_percentile":64687.24},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":9560.93,"10th_percentile":9560.93,"90th_percentile":9562.38},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":9590.27,"10th_percentile":9590.27,"90th_percentile":9590.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Gynecologic Procedures","code_information":[{"code":"5411","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"71","median_amount":351.75,"10th_percentile":102.27,"90th_percentile":700.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"16","median_amount":140.76,"10th_percentile":140.76,"90th_percentile":312.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"42","median_amount":1011.11,"10th_percentile":314.12,"90th_percentile":2202.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":1548.37,"10th_percentile":589.41,"90th_percentile":2434.45},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"31","median_amount":142.1,"10th_percentile":142.1,"90th_percentile":142.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"13","median_amount":448.28,"10th_percentile":448.28,"90th_percentile":448.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"138","median_amount":140.76,"10th_percentile":140.76,"90th_percentile":325.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"22","median_amount":1591.79,"10th_percentile":519.93,"90th_percentile":2721.32},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"24","median_amount":133.54,"10th_percentile":66.77,"90th_percentile":236.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Gynecologic Procedures","code_information":[{"code":"5414","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":3539.6,"10th_percentile":3539.6,"90th_percentile":3539.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":24797.49,"10th_percentile":24797.49,"90th_percentile":24797.49},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7093.96,"10th_percentile":7093.96,"90th_percentile":7093.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":1516.89,"10th_percentile":1516.89,"90th_percentile":1516.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":3306.08,"10th_percentile":3306.08,"90th_percentile":3306.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 5 Gynecologic Procedures","code_information":[{"code":"5415","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":11000.34,"10th_percentile":11000.34,"90th_percentile":11000.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Nerve Procedures","code_information":[{"code":"5431","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":9195.72,"10th_percentile":9195.72,"90th_percentile":9195.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":12215.1,"10th_percentile":12215.1,"90th_percentile":12215.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Nerve Injections","code_information":[{"code":"5441","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":397.49,"10th_percentile":397.49,"90th_percentile":397.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Nerve Injections","code_information":[{"code":"5442","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":255.71,"10th_percentile":255.71,"90th_percentile":255.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Neurostimulator and Related Procedures","code_information":[{"code":"5462","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":6806.43,"10th_percentile":6806.43,"90th_percentile":6806.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Neurostimulator and Related Procedures","code_information":[{"code":"5464","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":22240.4,"10th_percentile":22240.4,"90th_percentile":22240.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Intraocular Procedures","code_information":[{"code":"5491","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4.01,"10th_percentile":4.01,"90th_percentile":4.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2246.57,"10th_percentile":2246.57,"90th_percentile":2246.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Imaging without Contrast","code_information":[{"code":"5521","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"30","median_amount":199.14,"10th_percentile":70.51,"90th_percentile":664.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":37.37,"10th_percentile":37.37,"90th_percentile":42.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"64","median_amount":90.45,"10th_percentile":90.08,"90th_percentile":91.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"42","median_amount":175.72,"10th_percentile":121.58,"90th_percentile":326.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"50","median_amount":91.03,"10th_percentile":91.03,"90th_percentile":104.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"1 through 10","median_amount":214.34,"10th_percentile":148.92,"90th_percentile":438.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"18","median_amount":956.05,"10th_percentile":687.79,"90th_percentile":2455.66},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"1 through 10","median_amount":79.94,"10th_percentile":79.94,"90th_percentile":79.94},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"18","median_amount":37.73,"10th_percentile":37.73,"90th_percentile":56.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"31","median_amount":196.2,"10th_percentile":196.2,"90th_percentile":406.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"59","median_amount":37.37,"10th_percentile":37.37,"90th_percentile":110.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"33","median_amount":358.46,"10th_percentile":91.04,"90th_percentile":1083.1},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"91","median_amount":91.32,"10th_percentile":73.07,"90th_percentile":105.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Imaging without Contrast","code_information":[{"code":"5522","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"100","median_amount":284.27,"10th_percentile":95.06,"90th_percentile":821.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":62.42,"10th_percentile":37.37,"90th_percentile":83.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"124","median_amount":108.79,"10th_percentile":108.79,"90th_percentile":217.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"100","median_amount":291.94,"10th_percentile":111.23,"90th_percentile":640.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"67","median_amount":109.94,"10th_percentile":109.94,"90th_percentile":219.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"1 through 10","median_amount":442.4,"10th_percentile":306.71,"90th_percentile":907.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"31","median_amount":1789.12,"10th_percentile":789.54,"90th_percentile":2841.96},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"1 through 10","median_amount":187.56,"10th_percentile":187.56,"90th_percentile":187.56},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"1 through 10","median_amount":114.21,"10th_percentile":114.21,"90th_percentile":114.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":108.32,"10th_percentile":108.32,"90th_percentile":108.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"30","median_amount":75.47,"10th_percentile":42.71,"90th_percentile":207.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":110.88,"10th_percentile":110.88,"90th_percentile":110.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"78","median_amount":236.96,"10th_percentile":236.96,"90th_percentile":236.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"77","median_amount":65.97,"10th_percentile":37.37,"90th_percentile":110.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"66","median_amount":483.3,"10th_percentile":109.84,"90th_percentile":3022.02},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"173","median_amount":110.29,"10th_percentile":109.84,"90th_percentile":124.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":105.04,"10th_percentile":105.04,"90th_percentile":105.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 3 Imaging without Contrast","code_information":[{"code":"5523","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"19","median_amount":913.56,"10th_percentile":404.91,"90th_percentile":1732.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"27","median_amount":247.55,"10th_percentile":247.29,"90th_percentile":250.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"26","median_amount":629.41,"10th_percentile":348.04,"90th_percentile":1246.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"20","median_amount":249.91,"10th_percentile":249.91,"90th_percentile":249.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"1 through 10","median_amount":1073.56,"10th_percentile":869.52,"90th_percentile":1885.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":2333.65,"10th_percentile":2333.65,"90th_percentile":4335.79},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"1 through 10","median_amount":410.86,"10th_percentile":410.86,"90th_percentile":410.86},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":183.74,"10th_percentile":162.31,"90th_percentile":219.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"12","median_amount":538.64,"10th_percentile":538.64,"90th_percentile":538.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":110.54,"10th_percentile":110.54,"90th_percentile":147.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"12","median_amount":254.66,"10th_percentile":253.66,"90th_percentile":2058.56},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"78","median_amount":250.68,"10th_percentile":249.66,"90th_percentile":250.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Imaging without Contrast","code_information":[{"code":"5524","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":557.99,"10th_percentile":469.33,"90th_percentile":3178.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"16","median_amount":562.43,"10th_percentile":560.93,"90th_percentile":566.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":2356.47,"10th_percentile":1956.8,"90th_percentile":3203.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":566.88,"10th_percentile":566.88,"90th_percentile":570.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":2909.04,"10th_percentile":2704.91,"90th_percentile":3215.89},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"1 through 10","median_amount":1128.17,"10th_percentile":1128.17,"90th_percentile":1128.17},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1221.82,"10th_percentile":1221.82,"90th_percentile":1618.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":309.99,"10th_percentile":309.99,"90th_percentile":344.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":2836.8,"10th_percentile":571.33,"90th_percentile":2836.8},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"14","median_amount":568.64,"10th_percentile":568.64,"90th_percentile":735.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Imaging with Contrast","code_information":[{"code":"5571","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":924.91,"10th_percentile":859.61,"90th_percentile":1622.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":183.12,"10th_percentile":182.12,"90th_percentile":445.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":1145.93,"10th_percentile":903.22,"90th_percentile":1919.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":357.11,"10th_percentile":184.05,"90th_percentile":449.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"1 through 10","median_amount":537.91,"10th_percentile":537.91,"90th_percentile":537.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":1549.55,"10th_percentile":1549.55,"90th_percentile":1549.55},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"1 through 10","median_amount":375.74,"10th_percentile":375.74,"90th_percentile":375.74},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":270.77,"10th_percentile":270.77,"90th_percentile":270.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":396.69,"10th_percentile":396.69,"90th_percentile":396.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":78.79,"10th_percentile":78.79,"90th_percentile":78.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":4415.31,"10th_percentile":187.62,"90th_percentile":5195.26},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"19","median_amount":184.62,"10th_percentile":184.62,"90th_percentile":198.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Imaging with Contrast","code_information":[{"code":"5572","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":1395.35,"10th_percentile":1002.09,"90th_percentile":3120.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":217.25,"10th_percentile":217.25,"90th_percentile":217.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":369.36,"10th_percentile":366.85,"90th_percentile":549.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"13","median_amount":1418.5,"10th_percentile":1147.38,"90th_percentile":2150.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":369.23,"10th_percentile":369.23,"90th_percentile":369.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"1 through 10","median_amount":2261.6,"10th_percentile":2261.6,"90th_percentile":2261.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":10273.28,"10th_percentile":9510.21,"90th_percentile":12802.67},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":269.91,"10th_percentile":269.91,"90th_percentile":269.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":795.83,"10th_percentile":795.83,"90th_percentile":825.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":326.13,"10th_percentile":326.13,"90th_percentile":326.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":9227.42,"10th_percentile":6899.87,"90th_percentile":15333.02},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"21","median_amount":370.38,"10th_percentile":368.87,"90th_percentile":370.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Imaging with Contrast","code_information":[{"code":"5573","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":3934.97,"10th_percentile":3934.97,"90th_percentile":3934.97},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Nuclear Medicine and Related Services","code_information":[{"code":"5591","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":412.35,"10th_percentile":412.35,"90th_percentile":412.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":730.91,"10th_percentile":730.91,"90th_percentile":730.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":4412.9,"10th_percentile":4412.9,"90th_percentile":4412.9},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":895.44,"10th_percentile":895.44,"90th_percentile":895.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":248.88,"10th_percentile":248.88,"90th_percentile":248.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":416.74,"10th_percentile":416.74,"90th_percentile":526.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Nuclear Medicine and Related Services","code_information":[{"code":"5592","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":1991.47,"10th_percentile":1991.47,"90th_percentile":1991.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":644.45,"10th_percentile":644.45,"90th_percentile":644.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":894.51,"10th_percentile":894.51,"90th_percentile":1427.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"1 through 10","median_amount":1291.65,"10th_percentile":1291.65,"90th_percentile":1291.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":6847.12,"10th_percentile":6847.12,"90th_percentile":6847.12},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":251.25,"10th_percentile":251.25,"90th_percentile":251.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1199.47,"10th_percentile":1199.47,"90th_percentile":1199.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":317.4,"10th_percentile":317.4,"90th_percentile":317.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":3238.62,"10th_percentile":3238.62,"90th_percentile":3238.62},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":558.24,"10th_percentile":558.24,"90th_percentile":558.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Nuclear Medicine and Related Services","code_information":[{"code":"5593","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1339.27,"10th_percentile":1337.57,"90th_percentile":1339.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":2802.17,"10th_percentile":2802.17,"90th_percentile":2802.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":1349.72,"10th_percentile":1349.72,"90th_percentile":1349.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":710.54,"10th_percentile":710.54,"90th_percentile":710.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":8880.65,"10th_percentile":8880.65,"90th_percentile":8880.65},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":1353.92,"10th_percentile":1353.92,"90th_percentile":1353.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Nuclear Medicine and Related Services","code_information":[{"code":"5594","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":2456.29,"10th_percentile":2456.29,"90th_percentile":2456.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3250.3,"10th_percentile":3250.3,"90th_percentile":3250.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":9243.38,"10th_percentile":9243.38,"90th_percentile":9243.38},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":1623.0,"10th_percentile":1623.0,"90th_percentile":1623.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Radiation Therapy","code_information":[{"code":"5623","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":13482.42,"10th_percentile":13482.42,"90th_percentile":13482.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Pathology","code_information":[{"code":"5671","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":241.31,"10th_percentile":160.88,"90th_percentile":881.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":54.66,"10th_percentile":54.66,"90th_percentile":55.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":410.45,"10th_percentile":410.45,"90th_percentile":410.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":1090.7,"10th_percentile":1090.7,"90th_percentile":1090.7},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":41.58,"10th_percentile":41.58,"90th_percentile":41.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":12.13,"10th_percentile":12.13,"90th_percentile":22.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":715.92,"10th_percentile":715.92,"90th_percentile":715.92},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":56.31,"10th_percentile":56.31,"90th_percentile":56.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Pathology","code_information":[{"code":"5672","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":175.31,"10th_percentile":175.31,"90th_percentile":175.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"1 through 10","median_amount":184.05,"10th_percentile":184.05,"90th_percentile":184.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":381.86,"10th_percentile":381.86,"90th_percentile":381.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":177.0,"10th_percentile":177.0,"90th_percentile":180.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Pathology","code_information":[{"code":"5673","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":199.08,"10th_percentile":199.08,"90th_percentile":199.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":368.01,"10th_percentile":368.01,"90th_percentile":368.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":2414.72,"10th_percentile":2414.72,"90th_percentile":2414.72},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Drug Administration","code_information":[{"code":"5691","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4775.0,"10th_percentile":4775.0,"90th_percentile":4775.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":5858.57,"10th_percentile":5858.57,"90th_percentile":53445.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":2632.66,"10th_percentile":2632.66,"90th_percentile":2632.66},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":1052.61,"10th_percentile":1052.61,"90th_percentile":2884.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Drug Administration","code_information":[{"code":"5692","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":401.73,"10th_percentile":401.73,"90th_percentile":401.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":343.93,"10th_percentile":343.93,"90th_percentile":343.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":33.94,"10th_percentile":33.94,"90th_percentile":33.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":133.54,"10th_percentile":133.54,"90th_percentile":133.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Drug Administration","code_information":[{"code":"5693","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":588.58,"10th_percentile":327.91,"90th_percentile":1103.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":439.58,"10th_percentile":439.58,"90th_percentile":439.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":4832.98,"10th_percentile":4832.98,"90th_percentile":4832.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":534.72,"10th_percentile":463.67,"90th_percentile":584.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":235.49,"10th_percentile":70.38,"90th_percentile":550.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":447.24,"10th_percentile":447.24,"90th_percentile":447.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Drug Administration","code_information":[{"code":"5694","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1997.16,"10th_percentile":1997.16,"90th_percentile":1997.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Diagnostic Tests and Related Services","code_information":[{"code":"5721","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":652.0,"10th_percentile":207.3,"90th_percentile":1538.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":161.06,"10th_percentile":161.06,"90th_percentile":161.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":1317.0,"10th_percentile":778.2,"90th_percentile":1665.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":1328.36,"10th_percentile":1328.36,"90th_percentile":1328.36},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":348.65,"10th_percentile":348.65,"90th_percentile":348.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":100.43,"10th_percentile":100.43,"90th_percentile":100.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":1053.92,"10th_percentile":1053.92,"90th_percentile":1053.92},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":162.26,"10th_percentile":162.26,"90th_percentile":162.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Diagnostic Tests and Related Services","code_information":[{"code":"5722","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":2413.76,"10th_percentile":2413.76,"90th_percentile":2413.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":318.58,"10th_percentile":318.58,"90th_percentile":427.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":507.56,"10th_percentile":378.54,"90th_percentile":2767.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":321.96,"10th_percentile":321.96,"90th_percentile":321.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":2927.97,"10th_percentile":2538.15,"90th_percentile":4286.25},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":153.26,"10th_percentile":153.26,"90th_percentile":153.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":151.82,"10th_percentile":151.82,"90th_percentile":151.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":322.15,"10th_percentile":321.95,"90th_percentile":2238.94},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"19","median_amount":322.96,"10th_percentile":88.43,"90th_percentile":322.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Diagnostic Tests and Related Services","code_information":[{"code":"5724","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1040.85,"10th_percentile":1040.85,"90th_percentile":1040.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":8780.55,"10th_percentile":8780.55,"90th_percentile":8780.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":1051.88,"10th_percentile":1051.88,"90th_percentile":1051.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":10784.64,"10th_percentile":10784.64,"90th_percentile":10784.64},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2267.15,"10th_percentile":2267.15,"90th_percentile":2267.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":501.64,"10th_percentile":501.64,"90th_percentile":501.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":1051.15,"10th_percentile":1051.15,"90th_percentile":1051.15},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":66.77,"10th_percentile":66.77,"90th_percentile":1055.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Minor Procedures","code_information":[{"code":"5731","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":8.17,"10th_percentile":8.17,"90th_percentile":8.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Minor Procedures","code_information":[{"code":"5732","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":25.48,"10th_percentile":25.48,"90th_percentile":25.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Minor Procedures","code_information":[{"code":"5733","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":929.7,"10th_percentile":400.27,"90th_percentile":929.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":61.76,"10th_percentile":60.76,"90th_percentile":62.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":164.11,"10th_percentile":62.77,"90th_percentile":347.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":61.41,"10th_percentile":61.41,"90th_percentile":61.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":1435.1,"10th_percentile":1435.1,"90th_percentile":1435.1},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":17.88,"10th_percentile":17.88,"90th_percentile":17.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":132.36,"10th_percentile":132.36,"90th_percentile":132.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":17.71,"10th_percentile":17.71,"90th_percentile":25.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":1308.59,"10th_percentile":1308.59,"90th_percentile":1308.59},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":61.6,"10th_percentile":61.6,"90th_percentile":75.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Minor Procedures","code_information":[{"code":"5734","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":462.24,"10th_percentile":186.0,"90th_percentile":1019.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":131.88,"10th_percentile":131.88,"90th_percentile":131.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":634.22,"10th_percentile":327.27,"90th_percentile":872.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"1 through 10","median_amount":133.27,"10th_percentile":133.27,"90th_percentile":147.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":1225.9,"10th_percentile":643.48,"90th_percentile":2315.51},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"1 through 10","median_amount":138.45,"10th_percentile":138.45,"90th_percentile":138.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":29.16,"10th_percentile":29.16,"90th_percentile":29.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":134.41,"10th_percentile":134.41,"90th_percentile":134.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":287.25,"10th_percentile":287.25,"90th_percentile":287.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"17","median_amount":54.48,"10th_percentile":11.92,"90th_percentile":96.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":945.57,"10th_percentile":433.12,"90th_percentile":2567.16},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"14","median_amount":135.86,"10th_percentile":135.86,"90th_percentile":135.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Rehabilitation","code_information":[{"code":"5771","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"14","median_amount":103.39,"10th_percentile":103.39,"90th_percentile":103.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":102.42,"10th_percentile":102.42,"90th_percentile":102.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":66.77,"10th_percentile":66.77,"90th_percentile":66.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Resuscitation and Cardioversion","code_information":[{"code":"5781","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":3938.81,"10th_percentile":3938.81,"90th_percentile":3938.81},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Platelet pheres leukoreduced","code_information":[{"code":"9501","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"1 through 10","median_amount":1645.16,"10th_percentile":1645.16,"90th_percentile":1645.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Platelets pheresis path redu","code_information":[{"code":"9536","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1236.64,"10th_percentile":1236.64,"90th_percentile":1236.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"1 through 10","median_amount":1731.95,"10th_percentile":1298.3,"90th_percentile":2078.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Non-OPPS Clinic Services","code_information":[{"code":"N700","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":161.37,"10th_percentile":19.91,"90th_percentile":530.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"13","median_amount":449.47,"10th_percentile":216.57,"90th_percentile":802.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Clinical Diagnostic Lab Services","code_information":[{"code":"N800","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"399","median_amount":196.23,"10th_percentile":50.88,"90th_percentile":471.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"1 through 10","median_amount":159.63,"10th_percentile":159.63,"90th_percentile":159.63},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":7.9,"10th_percentile":7.9,"90th_percentile":7.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"341","median_amount":57.03,"10th_percentile":17.88,"90th_percentile":158.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"57","median_amount":597.74,"10th_percentile":218.5,"90th_percentile":2132.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"203","median_amount":44.03,"10th_percentile":18.07,"90th_percentile":131.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"1 through 10","median_amount":966.15,"10th_percentile":523.72,"90th_percentile":1721.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"50","median_amount":935.21,"10th_percentile":166.1,"90th_percentile":2387.77},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"1 through 10","median_amount":90.32,"10th_percentile":63.04,"90th_percentile":133.56},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"1 through 10","median_amount":13.38,"10th_percentile":13.38,"90th_percentile":13.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":70.16,"10th_percentile":63.21,"90th_percentile":72.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"54","median_amount":12.58,"10th_percentile":4.49,"90th_percentile":50.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":13.4,"10th_percentile":13.4,"90th_percentile":13.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"72","median_amount":153.76,"10th_percentile":35.86,"90th_percentile":386.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"198","median_amount":10.87,"10th_percentile":4.11,"90th_percentile":52.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"145","median_amount":127.57,"10th_percentile":26.06,"90th_percentile":1079.69},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"501","median_amount":66.49,"10th_percentile":18.23,"90th_percentile":166.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Therapy Services","code_information":[{"code":"N801","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":106.59,"10th_percentile":106.59,"90th_percentile":106.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":54.62,"10th_percentile":52.98,"90th_percentile":297.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":91.4,"10th_percentile":79.43,"90th_percentile":125.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":323.53,"10th_percentile":221.21,"90th_percentile":610.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"1 through 10","median_amount":504.46,"10th_percentile":504.46,"90th_percentile":504.46},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"14","median_amount":81.89,"10th_percentile":70.19,"90th_percentile":152.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":80.97,"10th_percentile":80.97,"90th_percentile":80.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":232.17,"10th_percentile":165.95,"90th_percentile":272.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"44","median_amount":34.76,"10th_percentile":23.17,"90th_percentile":164.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":541.88,"10th_percentile":541.88,"90th_percentile":541.88},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"11","median_amount":92.68,"10th_percentile":76.92,"90th_percentile":260.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Mammography Services","code_information":[{"code":"N804","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"49","median_amount":98.87,"10th_percentile":98.87,"90th_percentile":414.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"49","median_amount":108.32,"10th_percentile":108.32,"90th_percentile":108.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"55","median_amount":119.55,"10th_percentile":84.98,"90th_percentile":128.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"26","median_amount":109.47,"10th_percentile":109.47,"90th_percentile":109.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"1 through 10","median_amount":128.53,"10th_percentile":128.53,"90th_percentile":128.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"31","median_amount":569.82,"10th_percentile":467.94,"90th_percentile":569.82},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":118.96,"10th_percentile":118.96,"90th_percentile":118.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"1 through 10","median_amount":566.05,"10th_percentile":566.05,"90th_percentile":566.05},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":46.67,"10th_percentile":46.67,"90th_percentile":46.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"52","median_amount":235.95,"10th_percentile":235.95,"90th_percentile":235.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":46.23,"10th_percentile":46.23,"90th_percentile":46.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"20","median_amount":502.65,"10th_percentile":109.36,"90th_percentile":502.65},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"52","median_amount":109.36,"10th_percentile":109.36,"90th_percentile":109.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Non-covered Services","code_information":[{"code":"N900","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":128.63,"10th_percentile":128.63,"90th_percentile":128.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":155.53,"10th_percentile":155.53,"90th_percentile":155.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"1 through 10","median_amount":653.92,"10th_percentile":653.92,"90th_percentile":653.92},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Not Recognized by OPPS","code_information":[{"code":"N905","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery  (%BC): 71.8] [Cardiac Cath (%BC): 71.8] [Observation (%BC): 74.2] [Emergency Department (%BC): 74.2] [Radiology Fee Schedule: FEE SCHEDULE] [Laboratory (%BC): 71.8] [Occupational Therapy (%BC): 71.8] [Physical Therapy (%BC): 71.8] [Respiratory Services/Therapy  (%BC): 71.8] [Speech Therapy (%BC): 71.8] [All Other OP (%BC): 71.8]","count":"1 through 10","median_amount":885.95,"10th_percentile":885.95,"90th_percentile":885.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":63.6,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 38.78] [Cardiac Cath (%BC): 38.78] [Lithotripsy (%BC): 38.78] [PTCA (%BC): 38.78] [Observation (%BC): 45.95] [Emergency Department (%BC): 45.95] [Other Cardiac Testing (%BC): 43.89] [EEG (%BC): 43.89] [Chemotherapy (%BC): 43.89] [Nuclear Medicine (%BC): 10.76] [Radiation Therapy  (%BC): 43.89] [CT OP Scan (%BC): 10.76] [MRI OP (%BC): 10.76] [Positron Emission Tomography (%BC): 10.76] [Radiology (%BC): 10.76] [Laboratory (%BC): 43.89] [Occupational Therapy (%BC): 43.89] [Physical Therapy (%BC): 43.89] [Respiratory Services/Therapy  (%BC): 43.89] [Speech Therapy (%BC): 43.89] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 43.89] [All Other OP (%BC): 43.89]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 49.22] [Cardiac Cath (%BC): 49.22] [Lithotripsy (%BC): 49.22] [PTCA (%BC): 49.22] [Observation (%BC): 58.33] [Emergency Department (%BC): 58.33] [Other Cardiac Testing (%BC): 55.70] [EEG (%BC): 55.70] [Chemotherapy (%BC): 55.70] [Nuclear Medicine (%BC): 13.65] [Radiation Therapy  (%BC): 55.70] [CT OP Scan (%BC): 13.65] [MRI OP (%BC): 13.65] [Positron Emission Tomography (%BC): 13.65] [Radiology (%BC): 13.65] [Laboratory (%BC): 55.70] [Occupational Therapy (%BC): 55.70] [Physical Therapy (%BC): 55.70] [Respiratory Services/Therapy  (%BC): 55.70] [Speech Therapy (%BC): 55.70] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 55.70] [All Other OP (%BC): 55.70]","count":"1 through 10","median_amount":1071.26,"10th_percentile":1071.26,"90th_percentile":1071.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE] [All Other OP (%BC): 14.4933]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 37.75] [Cardiac Cath (%BC): 37.75] [Lithotripsy (%BC): 37.75] [PTCA (%BC): 37.75] [Observation (%BC): 44.71] [Emergency Department (%BC): 44.71] [Other Cardiac Testing (%BC): 42.68] [EEG (%BC): 42.68] [Chemotherapy (%BC): 42.68] [Nuclear Medicine (%BC): 10.47] [Radiation Therapy  (%BC): 42.68] [CT OP Scan (%BC): 10.47] [MRI OP (%BC): 10.47] [Positron Emission Tomography (%BC): 10.47] [Radiology (%BC): 10.47] [Laboratory (%BC): 42.68] [Occupational Therapy (%BC): 42.68] [Physical Therapy (%BC): 42.68] [Respiratory Services/Therapy  (%BC): 42.68] [Speech Therapy (%BC): 42.68] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 42.68] [All Other OP (%BC): 42.68]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 54.92] [Cardiac Cath (%BC): 54.92] [Lithotripsy (%BC): 54.92] [PTCA (%BC): 54.92] [Observation (%BC): 61.55] [Emergency Department (%BC): 61.55] [Other Cardiac Testing (%BC): 58.73] [EEG (%BC): 58.73] [Chemotherapy (%BC): 58.73] [Nuclear Medicine (%BC): 15.13] [Radiation Therapy  (%BC): 58.73] [CT OP Scan (%BC): 15.13] [MRI OP (%BC): 15.13] [Positron Emission Tomography (%BC): 15.13] [Radiology (%BC): 15.13] [Laboratory (%BC): 58.73] [Occupational Therapy (%BC): 58.73] [Physical Therapy (%BC): 58.73] [Respiratory Services/Therapy  (%BC): 58.73] [Speech Therapy (%BC): 58.73] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 58.73] [All Other OP (%BC): 58.73]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 64.99] [Cardiac Cath (%BC): 64.99] [Lithotripsy (%BC): 64.99] [PTCA (%BC): 64.99] [Observation (%BC): 72.65] [Emergency Department (%BC): 72.65] [Other Cardiac Testing (%BC): 66.92] [EEG (%BC): 66.92] [Chemotherapy (%BC): 66.92] [Nuclear Medicine (%BC): 16.27] [Radiation Therapy  (%BC): 66.92] [CT OP Scan (%BC): 16.27] [MRI OP (%BC): 16.27] [Positron Emission Tomography (%BC): 16.27] [Radiology (%BC): 16.27] [Laboratory (%BC): 66.92] [Occupational Therapy (%BC): 66.92] [Physical Therapy (%BC): 66.92] [Respiratory Services/Therapy  (%BC): 66.92] [Speech Therapy (%BC): 66.92] [Other Outpatient Implant (%BC): 16.69] [IV Therapy (%BC): 66.92] [All Other OP (%BC): 66.92]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.3,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE] [All Other OP (%BC): 50]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":66.64,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hypertensive Encephalopathy With Mcc","code_information":[{"code":"077","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hypertensive Encephalopathy With Cc","code_information":[{"code":"078","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hypertensive Encephalopathy Without Cc/Mcc","code_information":[{"code":"079","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Pacemaker Revision Or Device Replacement With Mcc","code_information":[{"code":"210","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Pacemaker Revision Or Device Replacement Without Mcc","code_information":[{"code":"211","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Deep Vein Thrombophlebitis With Cc/Mcc","code_information":[{"code":"294","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Deep Vein Thrombophlebitis Without Cc/Mcc","code_information":[{"code":"295","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Circulatory System O.R. Procedures With Mcc","code_information":[{"code":"361","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Circulatory System O.R. Procedures Without Mcc","code_information":[{"code":"362","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Knee Procedures With Principal Diagnosis Of Infection","code_information":[{"code":"400","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hip Or Knee Procedures With Principal Diagnosis Of Periprosthetic Joint Infection With Mcc Or Insert","code_information":[{"code":"403","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hip Or Knee Procedures With Principal Diagnosis Of Periprosthetic Joint Infection Without Mcc","code_information":[{"code":"404","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Revision Of Hip Or Knee Prosthesis","code_information":[{"code":"449","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Combined Anterior And Posterior Spinal Fusion With Mcc","code_information":[{"code":"453","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Combined Anterior And Posterior Spinal Fusion With Cc","code_information":[{"code":"454","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc","code_information":[{"code":"455","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Spinal Fusion Except Cervical With Mcc","code_information":[{"code":"459","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Spinal Fusion Except Cervical Without Mcc","code_information":[{"code":"460","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Arthroscopy","code_information":[{"code":"509","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extensive Or Complex Spinal Fusion Procedures Except Cervical With Mcc","code_information":[{"code":"523","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extensive Or Complex Spinal Fusion Procedures Except Cervical With Cc","code_information":[{"code":"524","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extensive Or Complex Spinal Fusion Procedures Except Cervical Without Cc/Mcc","code_information":[{"code":"525","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Uterine And Adnexa Procedures For Malignancy With Mcc","code_information":[{"code":"731","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Uterine And Adnexa Procedures For Malignancy With Cc","code_information":[{"code":"732","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [Bariatric Surgery-Case Rate: 10460]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":65.5,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Uterine And Adnexa Procedures For Malignancy Without Cc/Mcc","code_information":[{"code":"733","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Principal Diagnosis Invalid As Discharge Diagnosis","code_information":[{"code":"998","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Oscar","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"PHCS","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":75.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ungroupable","code_information":[{"code":"999","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 145379 | Total % of Charge: 64.3] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 17597 Days: 3 Additional Days: 2264] [Normal vag. Del. 2 day stay-Case Rate: 12570 Days: 2 Additional Days: 2264] [Nursery  Level 1- Boarder-Per Diem: 1174] [Nursery  Level 2-Per Diem: 2264] [Nursery  Level 3-Per Diem: 4946] [Nursery  Level 4-NICU-Per Diem: 5697] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 10000 (%BC): 28.6]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"ASA PPO","methodology":"percent of total billed charges","standard_charge_percentage":63.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Better Health Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":82.9,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Blue Select Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 42.16] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Health Options HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 51.01] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"My Blue HMO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 39.09] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Network Blue Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 232136 | Total % of Charge: 53] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"PPC PPO","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 171954 | Total % of Charge: 63.23] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [IP Prosthetics/Implants/Devices (%BC): 16.69]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":76.7,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Coventry/First Health","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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It is used when only the technical portion of a test is billed, typically by hospitals, imaging centers, or independent diagnostic testing facilities","code":"TC","modifier_payer_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Sunshine Health","plan_name":"Ambetter Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."}]}]}